本文選題：心房顫動(dòng) + 血小板微粒�。� 參考：《石河子大學(xué)》2017年碩士論文

【摘要】：目的通過觀察非瓣膜性房顫患者血漿中血小板微粒(Platelet-derived Microparticle,PMP)的數(shù)量變化,明確PMP在房顫血栓形成中的作用;同時(shí)觀察房顫患者血清Hs-CRP的水平變化,并探討PMP與Hs-CRP的相關(guān)性。方法采用病例對照研究的方法,選取109例非瓣膜性房顫患者作為研究組(男66例,女43例,平均年齡68.53±10.41歲),另選取竇性心律患者44例作為對照組(男23例,女21例,平均年齡67.11±7.88歲)。本研究中根據(jù)CHADS2卒中風(fēng)險(xiǎn)評分標(biāo)準(zhǔn),將房顫患者分為低中危組和高危組2個(gè)亞組;另根據(jù)患者房顫分型,將房顫患者分為永久性房顫、持續(xù)性房顫、陣發(fā)性房顫3個(gè)亞組。采用流式細(xì)胞術(shù)對血漿中PMP數(shù)量進(jìn)行檢測,同時(shí)收集并記錄血清Hs-CRP、NT-proBNP、D-D、FIB以及心臟彩超LAD、LVEF等指標(biāo),并分析PMP與臨床各指標(biāo)的相關(guān)性。結(jié)果(1)非瓣膜性房顫患者與對照組相比PMP、Hs-CRP、NT-proBNP、D-D、FIB等水平均升高,LAD增大、LVEF降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);(2)永久性房顫患者與陣發(fā)性房顫患者相比,PMP、Hs-CRP、NT-ProBNP、FIB水平均升高,LAD增大、LVEF降低;與持續(xù)性房顫比較,Hs-CRP、FIB水平升高;差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)CHADS2高危組與CHADS2低中危組比較,PMP、Hs-CRP、NT-ProBNP、D-D、FIB水平均升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)房顫患者血漿PMP表達(dá)水平與Hs-CRP呈正相關(guān)(r=0.020,P=0.019),PMP=4.543+0.092Hs-CRP。結(jié)論(1)非瓣膜性房顫患者PMP水平升高,隨著房顫持續(xù)時(shí)間延長、卒中風(fēng)險(xiǎn)升高PMP數(shù)量增加,提示PMP可能參與房顫血栓形成的病理生理過程,促進(jìn)血栓形成。(2)PMP與炎癥因子Hs-CRP之間存在正相關(guān)性,提示PMP與Hs-CRP之間存在相互作用,PMP可能通過促炎癥反應(yīng)進(jìn)一步促進(jìn)血栓形成。
[Abstract]:Objective to investigate the role of PMP in the formation of atrial fibrillation thrombus by observing the changes of platelet-derived microparticle PMP in plasma of patients with non-valvular atrial fibrillation, and to observe the level of serum Hs-CRP in patients with atrial fibrillation, and to explore the correlation between PMP and Hs-CRP. Methods 109 patients with non-valvular atrial fibrillation (66 males, 43 females, mean age 68.53 鹵10.41 years old) and 44 patients with sinus rhythm (23 males and 21 females) were selected as the control group. The mean age was 67.11 鹵7.88 years old. According to the CHADS2 stroke risk score, the patients with AF were divided into two subgroups: low, moderate risk group and high risk group, and according to the type of atrial fibrillation, the patients were divided into permanent atrial fibrillation group, persistent atrial fibrillation group and paroxysmal atrial fibrillation subgroup. The quantity of PMP in plasma was detected by flow cytometry, and the indexes of serum Hs-CRPP-NT-proBNP-D-DIBand LADD-LVEF were collected and recorded at the same time, and the correlation between PMP and clinical indexes was analyzed. Results 1) PMPHs-CRPNT-ProBNPFIB and other levels in patients with non-valvular atrial fibrillation increased, lad increased and LVEF decreased. The difference was statistically significant (P 0.05). The levels of PMPHs-CRPNT-ProBNPFIB in patients with permanent atrial fibrillation were higher than those in patients with paroxysmal atrial fibrillation. Compared with persistent atrial fibrillation, the FIB level of Hs-CRPN was higher than that of persistent atrial fibrillation, and there was a significant difference between the high risk group and the low and moderate risk group of CHADS2. There was a positive correlation between the plasma PMP expression level and Hs-CRP in patients with atrial fibrillation (P 0.05.4.543 0.092Hs-CRPNT-ProBNP-D-DFIB). Conclusion 1) the level of PMP in patients with non-valvular atrial fibrillation increased, and the number of PMP increased with the prolongation of AF, suggesting that PMP may be involved in the pathophysiological process of atrial fibrillation thrombosis. There was a positive correlation between PMP and Hs-CRP, which suggested that the interaction between PMP and Hs-CRP might further promote thrombosis by promoting inflammation.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.75

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