心房颤动心房扑动患者CRP与纤维蛋白原变化及与左心房内径的关系.doc

心房颤动、心房扑动患者CRP和纤维蛋白原变化及与左心房内径的关系 （作者:___________单位: ___________邮编: ___________） 【摘要】 　　目的 对比研究不同持续时间心房颤动(AF)和心房扑动(AFL)患者的C反应蛋白(CRP)、纤维蛋白原(Fib)、左心房(LA)内径的变化，探讨它们之间的关系。方法 选择AF患者53例(阵发性16例，持续性13例，永久性24例)；AFL者18例；窦性心律(SR)者32例。所有患者均做心电图、动态心电图、超声心动图，并检测Fib、CRP及有关实验检查。AFL组及各AF亚组的指标相互比较，并分别与SR组比较，将CRP与LA内径做相关性分析。结果 AF组与AFL、SR组的Fib、CRP、LA内径比较差异有统计学意义；AFL与SR组之间无统计学意义。三组之间的其他指标无统计学意义。持续性和永久性AF组的CRP与AFL、SR、阵发性AF组比较差异有统计学意义。持续性AF组的LA内径与SR组比较差异有统计学意义，与AFL组比较无统计学意义；永久性AF组与阵发性AF、AFL、SR组的LA内径之间差异有统计学意义。AF组的LA内径与CRP之间存在直线相关性，r=0.33。结论 AF均处于高凝状态；CRP的升高可能是AF的结果，并且与AF的持续时间有关；LA内径与炎症反应呈正相关；AFL不存在高凝状态。 【关键词】 心房扑动；心房颤动；纤维蛋白原；左心房；C反应蛋白 　　ABSTRACT: Objective To compare the changes in fibrinogen (Fib), Creactive protein (CRP) and left atrial (LA) size between patients with atrial flatter (AFL) and those with atrial fibrillation (AF) to explore the relations among them. Methods We selected 53 AF patients (including 16 cases of paroxymal AF, 13 of persistent AF and 24 of permanent AF) and 18 patients with AFL; the control group consisted of 32 cases of sinus rhythm (SR). In all the patients, ECG or Horter and UCG were conducted; Fib and CRP were measured. The levels of the above indexes in AF group, AFL group and subgroups were compared with each other, and with those in the control group. Correlation analysis between CRP and LA size was made. Results Fib, CRP and LA size in AF group were significantly different from those in AFL and SR groups, but did not differ between the latter two groups. So did other parameters among the three groups. CRP in persistent AF and permanent AF differed significantly from that in AFL, SR and paraxymal AF. LA size in the groups of persistent AF differed from that in SR group, but there was no difference between those in persistent AF and AFL groups. LA size in permanent AF was significantly different from that in AF, AFL and SR. Positive significant linear correlations were found between CRP and LA size in AF (r=0.33). Conclusion Hypercoagulable state