摘要
目的:探讨机械瓣置换术后低强度抗凝对凝血激活的影响。方法:将137例机械瓣置换术后口服华法林抗凝的患者,根据抗凝强度(INR值)分成3组:A组(1.5≤INR<2.0),44例;B组(2.0≤INR<3.0),61例;C组(3.0≤INR<4.5),32例。20例正常成人为对照组。采用酶联免疫吸附法(ELISA)测定各组患者血浆凝血酶原片段1+2(F1+2),D-二聚体浓度。结果:A,B,C和正常组F1+2浓度分别为(1.23±0.65),(0.81±0.45),(0.73±0.39),(1.11±0.35)nmol/L。D-二聚体浓度分别为(0.30±0.17),(0.24±0.10),(0.25±0.11),(0.21±0.09)mg/L。A组F1+2浓度与正常对照组无差异(P>0.05),D-二聚体浓度显著高于正常对照组(P<0.05);B,C组F1+2浓度均显著低于正常对照组(P<0.05),但二者之间无显著差异(P>0.05);B,C组D-二聚体浓度与正常对照组之间均无显著差异(P>0.05)。结论:低强度抗凝使机械瓣置换术后患者凝血激活受到明显抑制。
Objective: To study the influence of low intensity anticoagulation on coagulation activation in patients with mechanical heart valve prostheses. Methods: A total of 137 patients received cardiac valve replacement were randomized into 3 groups according to anticoagulation intensity (INR): group A (INR 1.5～1.99), 44 patients; group B(INR 2.0～2.99), 61 patients; group C(INR 3.0～4.5), 32 patients. The cntrol group included 20 health persons. Prothrombin fragment 1+2 (F 1+2 ) and D dimer were measured by ELISA. Results: In group A, B, C and control groups,F 1+2 values were 1.23±0.65, 0.81±0 45, 0.73±0.39 and 1.11±0.35 nmol/L, respectively, D dimer values were 0.30±0.17, 0.24±0.10, 0 25±0 11 and 0.21±0.09 mg/L, respectively. F 1+2 values in group A were the same as normal controls ( P >0.05); In group B and C F 1+2 value were signficantly lower than in normal controls ( P <0.05), however, there were no difference between group B and C ( P >0.05). The D dimer values in group A were markedly higher than in normal group ( P <0.05). Group B and C were not different from normal controls ( P >0 05). Conclusion: Low intensity anticoagulation has significant inhibition against blood coagulation activation in patients with mechanical heart valve prostheses.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
1999年第12期1009-1011,共3页
Academic Journal of Second Military Medical University
基金
全军"九五"医药卫生科研基金!项目编号96 Z0 3 1
关键词
心脏瓣膜置换术
凝血酶原
D-二聚体
heart valve replacement
anticoagulation therapy
prothrombin
D-dimer
