非瓣膜病心房颤动患者血小板活化状态的研究

目的了解非瓣膜病心房颤动(房颤)患者血小板的活化状态。方法观察92例非瓣膜病持续性房颤患者(房颤组)与60例窦性心律者(对照组)血小板功能状态的分子标记物水平,用酶联免疫吸附双抗体夹心法测定血浆血小板α颗粒膜糖蛋白-140(GMP-140)水平,用放射免疫分析法测定血栓素B2(TXB2)和6-酮-前列腺素F1α(6-k-PGF1α)水平。结果房颤组GMP-140和TXB2水平显著高于对照组,6-k-PGF1α水平显著低于对照组,TXB2/6-k-PGF1α比值也显著高于对照组。调整其他影响因素后,房颤组GMP-140和TXB2水平仍显著高于对照组,6-k-PGF1α水平仍显著低于对照组。GMP-140水平在合并糖尿病和合并高甘油三酯血症的房颤患者进一步升高。结论非瓣膜病房颤患者处于血小板激活状态。

Changes of platelet activity in middle-old aged patients with nonvalvular atrial fibrillation

Objective To study the changes of platelet activity in patients with nonvalvular atrial fibrillation.Methods Levels of platelet activity markers were measured in 92 patients aged 45～80 with persistent nonvalvular atrial fibrillation(AF group) and 60 patients with sinus rhythm(control group).Enzyme linked immunosorbent assay was used to measure plasma platelet granular membrane protein-140(GMP-140) and radioimmunoassay was used to measure plasma thromboxane B_2(TXB_2) and 6-keto-prostaglandin F_(1α)(6-k-PGF_(1α)).Results The patients in AF group had significantly higher plasma GMP-140 and TXB_2 and lower plasma(6-k-PGF_(1α)) compared with the patients in control group.The patients in AF group also had significantly higher ratio of TXB_2/ 6-k-PGF_(1α).Multivariate analysis showed that the differences of GMP-140,TXB_2 and 6-k-PGF_(1α) between the 2 groups were not affected by the other factors.In AF group,plasma level of GMP-140 was higher in the patients complicated by diabetes and hypertriglyceridemia.Conclusion The present results indicated that the patients with nonvalvular atrial fibrillation are in the state of platelet activation.