血小板微粒（PMP）在房颤患者血浆中的变化及与Hs-CRP的相关性分析

发布时间：2018-05-02 06:45

本文选题：心房颤动 + 血小板微粒　；参考：《石河子大学》2017年硕士论文

【摘要】：目的通过观察非瓣膜性房颤患者血浆中血小板微粒(Platelet-derived Microparticle,PMP)的数量变化,明确PMP在房颤血栓形成中的作用;同时观察房颤患者血清Hs-CRP的水平变化,并探讨PMP与Hs-CRP的相关性。方法采用病例对照研究的方法,选取109例非瓣膜性房颤患者作为研究组(男66例,女43例,平均年龄68.53±10.41岁),另选取窦性心律患者44例作为对照组(男23例,女21例,平均年龄67.11±7.88岁)。本研究中根据CHADS2卒中风险评分标准,将房颤患者分为低中危组和高危组2个亚组;另根据患者房颤分型,将房颤患者分为永久性房颤、持续性房颤、阵发性房颤3个亚组。采用流式细胞术对血浆中PMP数量进行检测,同时收集并记录血清Hs-CRP、NT-proBNP、D-D、FIB以及心脏彩超LAD、LVEF等指标,并分析PMP与临床各指标的相关性。结果(1)非瓣膜性房颤患者与对照组相比PMP、Hs-CRP、NT-proBNP、D-D、FIB等水平均升高,LAD增大、LVEF降低,差异具有统计学意义(P0.05);(2)永久性房颤患者与阵发性房颤患者相比,PMP、Hs-CRP、NT-ProBNP、FIB水平均升高,LAD增大、LVEF降低;与持续性房颤比较,Hs-CRP、FIB水平升高;差异均有统计学意义(P0.05)。(3)CHADS2高危组与CHADS2低中危组比较,PMP、Hs-CRP、NT-ProBNP、D-D、FIB水平均升高,差异有统计学意义(P0.05)。(4)房颤患者血浆PMP表达水平与Hs-CRP呈正相关(r=0.020,P=0.019),PMP=4.543+0.092Hs-CRP。结论(1)非瓣膜性房颤患者PMP水平升高,随着房颤持续时间延长、卒中风险升高PMP数量增加,提示PMP可能参与房颤血栓形成的病理生理过程,促进血栓形成。(2)PMP与炎症因子Hs-CRP之间存在正相关性,提示PMP与Hs-CRP之间存在相互作用,PMP可能通过促炎症反应进一步促进血栓形成。
[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 卤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 卤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.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.75

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