CAJ | 학술논문

目的：探讨房颤患者血清D-二聚体、B型钠尿肽水平及其对血栓形成的预测作用。方法房颤患者55例，按治疗期间是否发生左心房血栓及外周动脉血栓栓塞并发症分为血栓形成组（25例）和非血栓组（30例），比较两组患者血栓形成前的血清D-二聚体、钠尿肽、C 反应蛋白（ CRP）水平，以及凝血酶原时间（ PT）、活化部分凝血酶原时间（ APTT ），左心房内径（ LAD ）、左室射血分数（ LVEF ）、左心室舒张期内径（ LVEDD）。结果血栓形成组血栓形成之前的血清D-二聚体、钠尿肽、CRP、LAD、LVEDD、PT、APTT指标均显著高于非血栓组（P＜0．05），血栓形成之前的LVEF低于非血栓组（P＜0．05）。血清D-二聚体的ROC曲线下面积为0．933（95％的可信区间0．872～0．993，P＜0．001）。血清钠尿肽的ROC曲线下面积为0．842（95％的可信区间0．741～0．843，P＜0．001）。结论血清D-二聚体、钠尿肽水平，可以作为预测房颤患者血栓形成的指标，血清D-二聚体对血栓形成的预测价值高于血清钠尿肽。
목적：탐토방전환자혈청D-이취체、B형납뇨태수평급기대혈전형성적예측작용。방법방전환자55례，안치료기간시부발생좌심방혈전급외주동맥혈전전새병발증분위혈전형성조（25례）화비혈전조（30례），비교량조환자혈전형성전적혈청D-이취체、납뇨태、C 반응단백（ CRP）수평，이급응혈매원시간（ PT）、활화부분응혈매원시간（ APTT ），좌심방내경（ LAD ）、좌실사혈분수（ LVEF ）、좌심실서장기내경（ LVEDD）。결과혈전형성조혈전형성지전적혈청D-이취체、납뇨태、CRP、LAD、LVEDD、PT、APTT지표균현저고우비혈전조（P＜0．05），혈전형성지전적LVEF저우비혈전조（P＜0．05）。혈청D-이취체적ROC곡선하면적위0．933（95％적가신구간0．872～0．993，P＜0．001）。혈청납뇨태적ROC곡선하면적위0．842（95％적가신구간0．741～0．843，P＜0．001）。결론혈청D-이취체、납뇨태수평，가이작위예측방전환자혈전형성적지표，혈청D-이취체대혈전형성적예측개치고우혈청납뇨태。
Objective To investigate serum D-dimer,natriureticpeptide levels and their roles in prediction of thrombosis among patients with atrial fibrillation ( AF) .Methods Fifty-five AF patients were divided into thrombosis group(n=25) and non-thrombosis group(n=30) according to whether they suffered from left atrial thrombosis and peripheral arterial thromboembolic complications or not .The D-dimer,natriureticpeptide and C reactive protein ( CRP) levels,prothrombin time(PT),activated partial prothrombin time(APTT),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular diastolic diameter(LVEDD) were compared between two groups.Results Before thrombosis,the levels of D-dimer,natriureticpeptide and CRP,LAD,LVEDD,PT,APTT in the thrombosis group were significantly higher than those in the non-thrombosis group(P<0.05),LVEF in the thrombosis group was lower than that in the non-thrombosis group(P<0.05).The value of area under receiver operating characteristic (ROC) curve of serum D-dimer was 0.933[95% confidence interval(CI) 0.872-0.993,P<0.001].The value of area under ROC curve of serum natriureticpeptide was 0.842(95%CI 0.741-0.843,P<0.001).Conclusion Serum levels of D-dimer and natriureticpeptide can be used as the indexes for predicting the thrombosis in AF patients .Serum D-dimer is more valuable in the prediction of thrombosis compared with serum natriureticpeptide .