脂蛋白(a)在评估慢性房颤患者左心房血栓形成中的临床价值

目的 :探讨脂蛋白 (a) Lp(a) ]在慢性房颤患者左心房血栓形成中的价值。方法 :对 6 2例慢性房颤患者实施经食道超声检查 (TEE)或二尖瓣置换术探查左心房血栓 ,同时检测血Lp(a)、D 二聚体 (D Dimer)和纤溶酶原活性 (PIg)等凝血指标 ,并对其结果进行对照性分析。结果 :(1)高Lp(a)水平患者左心房血栓检出率为 5 6 %明显高于低Lp(a)水平者血栓检出率 13 % (P =0 .0 0 13)。 (2 ) 45例慢性房颤患者经TEE检查发现左心房自发显影 (SEC)≥ 2级者 2 8例。其中 ,高Lp(a)水平者 5例 ,血栓发生率占 10 0 % ;低Lp(a)水平者 2 3例 ,发生血栓者 4例 ,血栓发生率占 17% (P =0 .0 0 135 )。 (3)血栓组D Dimer、Lp(a)水平明显高于非血栓组 ;高Lp(a)水平组D Dimer水平明显高于低Lp(a)水平组。结论 :高Lp(a)水平与左心房血栓形成高度相关 ,是慢性房颤患者左心房血栓形成的危险因子

Clinical valuation of liporotein(a) in evalued left atrial thrombus of patients with chronic atrial fibrillation

Objective： To explore the valutation of Lp(a) for left atrial thrombus in patients with chronic atrial fibrillation.Methods： 62 patients with chronic atrial fibrillation underwent transesophageal echocardiography(TEE) or mitral valve replacement surgery to detect left atrial thrombus,measure serum concentration of lipoprotein(a),D-dimer,Plasminogen activity level etc,analysing their result contrastively.Results： (1)Left atrial thrombus was significantly more frequency in the high-Lp(a) group(56%) than in the low-Lp(a) group(13%) (P=0.0013).(2)There are 28 patients with spontaneous echo contrast(SEC) of left atrium≥2 grade in the 45 patients detected by TEE,left artial thrombus were present in 5(100%) of 5 patiens with high-Lp(a) and SEC.left atrial thrombus were present in 4(17%) of 23 patiens with low-Lp(a) and SEC (P=0.00135).(3)The levels of Lp(a) and D-Dimer were highter in the patients with left atrial thrombus than the patients without left atrial thrombus.Conclusion: Elevated serum levels of Lp(a) relate to thrombosis and it is a risk factor for left atrial thrombosis in patiens with chronic atrial fibrillation.