【摘要】：目的：探討繼發(fā)型房間隔缺損相關(guān)性肺動脈高壓與血小板活化標(biāo)志物平均血小板體積(MPV)的關(guān)系及其繼發(fā)型房間隔缺損相關(guān)性肺動脈高壓的影響因素。方法：選擇2010年1月至2014年3月就診于新疆醫(yī)科大學(xué)第一附屬醫(yī)院心臟中心的先天性心臟病患者中繼發(fā)型房間隔缺損患者627例,根據(jù)有無肺動脈高壓(PAH)分為無PAH組207例,有PAH組420例；另外選擇同時(shí)間段就診于新疆醫(yī)科大學(xué)第一附屬醫(yī)院體檢中心的690例健康人群作為對照組。所有患者均進(jìn)行血細(xì)胞參數(shù)、生化、心電圖等的測定,其中,繼發(fā)孔型房間隔缺損患者均進(jìn)行右心導(dǎo)管檢查。結(jié)果：(1)繼發(fā)孔型房間隔缺損組較正常對照具有較高的MPV值(P0.001),在有無肺動脈高壓組間比較MPV值,兩組間MPV值無統(tǒng)計(jì)學(xué)差異(P=-0.268)。(2)對繼發(fā)孔型房間隔缺損相關(guān)性肺動脈高壓獨(dú)立影響因素的Logistic回歸分析發(fā)現(xiàn)：年齡(每10年,OR=1.401,95% CI 1.087 to 1.806, P=0.009),右室直徑(OR=1.101,95% CI 1.026 to1.181,P=0.008),缺損直徑(OR=1.064,95% CI 1.013 to 1.118, P=0.013)是繼發(fā)孔型房間隔缺損相關(guān)性肺動脈高壓的獨(dú)立危險(xiǎn)因素。結(jié)論：年齡、右室直徑、房間隔缺損直徑是繼發(fā)孔型房間隔缺損所致肺動脈高壓的獨(dú)立危險(xiǎn)因素。肺動脈高壓患者中存在血小板活化,而血小板活化可能不是影響肺動脈高壓發(fā)生、發(fā)展的直接原因。
[Abstract]:Objective: to investigate the relationship between secondary atrial septal defect associated pulmonary hypertension and platelet activation marker mean platelet volume (MPV) and the influencing factors of secondary atrial septal defect associated pulmonary hypertension. Methods: from January 2010 to March 2014, 627 patients with recurrent atrial septal defect (ASD) who were admitted to the heart center of the first affiliated Hospital of Xinjiang Medical University were randomly divided into two groups: PAH group (n = 207) and (PAH) with or without pulmonary hypertension. There were 420 cases in PAH group and 690 healthy people in the physical examination center of the first affiliated Hospital of Xinjiang Medical University at the same time as control group. Blood cell parameters, biochemical parameters, electrocardiogram were measured in all patients, and right cardiac catheterization was performed in all patients with secondary atrial septal defect. Results: (1) the MPV value of ASD group was higher than that of the normal control group (P0. 001), and the MPV value was higher in the group with or without pulmonary hypertension (P0. 001). There was no significant difference in MPV between the two groups (P = 0.268). (2). The Logistic regression analysis of the independent factors of pulmonary hypertension associated with secondary atrial septal defect found that age (1.401% CI 1.087 to 1.806 per 10 years), right ventricular diameter (OR 1.101 95% CI 1.026 to 1.181 P0. 008), defect diameter (OR1.064%), and the diameter of defect (OR1.064%, P 0.008) were not significantly different between the two groups. CI 1.013 to 1.118, Pu 0.013) is an independent risk factor for pulmonary hypertension associated with secondary atrial septal defect. Conclusion: age, diameter of right ventricle and diameter of atrial septal defect are independent risk factors for pulmonary hypertension caused by secondary atrial septal defect. There is platelet activation in patients with pulmonary hypertension, and platelet activation may not be a direct cause of the occurrence and development of pulmonary hypertension.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.1;R544.1
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本文編號：2146771