心脏瓣膜置换术后动态监测血栓前体蛋白的临床价值分析

目的动态监测分析血栓前体蛋白（TpP）对心脏瓣膜置换术后抗凝治疗及检测的临床价值。方法收集2012年5月～2013年5月于本院开展心脏瓣膜置换术的40例患者为研究对象,将其随机均分为观察组和对照组,两组均于术前1d,术中（开放主动脉30min后）,术后第2、3天检测各项指标,其中对照组仅检测凝血酶原时间（PT）、国际标准化比值（INR）,观察组同时检测TpP、PT和INR,比较两组的INR和PT值,评价敏感性。结果两组术前1d,术中,术后第2、3天PT及INR差异无统计学意义（P〉0．05）。两组脑栓塞、轻度出血发生率差异无统计学意义（P〉0．05）。心房颤动与窦性心律患者的INR比较,差异无统计学意义（P〉0．05）,TpP比较,差异有统计学意义（P〈0．05）。结论TpP和INR等重要抗凝指标虽不存在显著的相关性,但对其进行检测能够有效地指导开展抗凝治疗,特别是患者ToP值过低时,应该注意其出血威胁。

Clinical analysis of dynamic monitoring thrombus precursor protein after heart valve replacement

Objective To investigate the clinical value of dynamic monitoring thrombus precursor protein （TpP） after heart valve replacement. Methods 40 cases of patients with heart valve replacement in our hospital from May 2012 to May 2013 were selected as the research objects,who were randomly divided into observation group and control group,20 cases in each group,the index of two groups 1 d preoperative,intra-operative （open aortic 30 min）,eaeh postoperative 2 d, 3 d were detected,of which only the prothrombin time （PT）,international standardization ratio （INR） were examined in control group,at the same time,the TpP,PT and INR were examined in observation group.The INR and PT of two groups was compared. Results The PT and INR of two groups 1 d preoperative,intra-operative,each postoperative 2 d,3 d had no significant difference （P〉0.05）.The incidence of cerebral embolism and mild bleeding of two groups had no significant difference （P〉0.05）.The INR of patients with atrial fibrillation and sinus rhythm had no significant difference （P〉 0.05）,but the TpP had significant difference （P〈0.05）. Conclusion The important indexes of TpP and INR do not have significant correlation,but their examination can effectively guide the anticoagulant treatment,especially those who with the TpP value too low,the bleeding threatening should be paid attention to.