平均血小板体积（MPV）与继发孔型房间隔缺损相关性肺动脉高压关系的研究

发布时间：2018-07-26 17:37

【摘要】：目的：探讨继发型房间隔缺损相关性肺动脉高压与血小板活化标志物平均血小板体积(MPV)的关系及其继发型房间隔缺损相关性肺动脉高压的影响因素。方法：选择2010年1月至2014年3月就诊于新疆医科大学第一附属医院心脏中心的先天性心脏病患者中继发型房间隔缺损患者627例,根据有无肺动脉高压(PAH)分为无PAH组207例,有PAH组420例；另外选择同时间段就诊于新疆医科大学第一附属医院体检中心的690例健康人群作为对照组。所有患者均进行血细胞参数、生化、心电图等的测定,其中,继发孔型房间隔缺损患者均进行右心导管检查。结果：(1)继发孔型房间隔缺损组较正常对照具有较高的MPV值(P0.001),在有无肺动脉高压组间比较MPV值,两组间MPV值无统计学差异(P=-0.268)。(2)对继发孔型房间隔缺损相关性肺动脉高压独立影响因素的Logistic回归分析发现：年龄(每10年,OR=1.401,95% CI 1.087 to 1.806, P=0.009),右室直径(OR=1.101,95% CI 1.026 to1.181,P=0.008),缺损直径(OR=1.064,95% CI 1.013 to 1.118, P=0.013)是继发孔型房间隔缺损相关性肺动脉高压的独立危险因素。结论：年龄、右室直径、房间隔缺损直径是继发孔型房间隔缺损所致肺动脉高压的独立危险因素。肺动脉高压患者中存在血小板活化,而血小板活化可能不是影响肺动脉高压发生、发展的直接原因。
[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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.1;R544.1
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本文编号：2146771