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目的检测心房颤动(AF)患者血浆组织因子(TF)和组织因子途径抑制物(TFPI)抗原的变化,探讨组织因子凝血途径在心房血栓形成机制中的作用。方法选择心房颤动患者64例,采用酶联免疫吸附(ELISA)方法测定血浆TF和TFPI抗原水平,并与对照组进行比较。结果①与正常对照组比较,AF组血浆TF抗原水平显著增高[(1060.0±669.8)pg/mLvs(423.6±245.1)pg/mL,P=0.000],总TFPI和游离TFPI抗原水平降低[(38.2±8.9)ng/mLvs(70.1±24.0)ng/mL,P=0.000;(26.3±8.0)ng/mLvs(41.2±16.7)ng/mL,P=0.000]。②伴左房血栓心房颤动组与无左房血栓心房颤动组比较,伴左房血栓心房颤动组TF抗原水平显著增高[(1431.4±564.5)pg/mLvs(904.6±660.3)pg/mL,P=0.004],总TFPI和游离TFPI抗原水平降低[(33.1±9.6)ng/mLvs(40.0±7.8)ng/mL,P=0.01;(22.9±8.2)ng/mLvs(22.7±7.4)ng/mL,P=0.048]。结论心房颤动患者血浆组织因子途径改变表现为凝血活性增高和抗凝活性减低,组织因子凝血途径参与了心房颤动患者心房血栓形成机制。
Objective To detect the changes of plasma Tissue Factor (TF) and Tissue Factor (TFPI) antigens in patients with atrial fibrillation (AF) and explore the role of tissue factor coagulation pathway in atrial thrombosis. Methods Sixty-four patients with atrial fibrillation were enrolled in this study. Plasma TF and TFPI antigen levels were measured by enzyme-linked immunosorbent assay (ELISA) and compared with that of the control group. Results ① Compared with the normal control group, the level of TF antigen in AF group was significantly higher than that in the control group [(1060.0 ± 669.8) pg / mL vs (423.6 ± 245.1) pg / mL, P = 0.000] ± 8.9 ng / mL vs 70.1 ± 24.0 ng / mL, P = 0.000; (26.3 ± 8.0) ng / mL vs (41.2 ± 16.7) ng / mL, P = 0.000). ② Compared with left atrial thrombus and atrial fibrillation group, the level of TF antigen in left atrial thrombus atrial fibrillation group was significantly higher than that in left atrium thrombus atrial fibrillation group [(1431.4 ± 564.5) pg / mL vs (904.6 ± 660.3) pg / mL, P = 0.004], and the total TFPI and free TFPI antigen levels were significantly lower (33.1 ± 9.6 ng / mL vs 40.0 ± 7.8 ng / mL, P = 0.01; 22.9 ± 8.2 ng / mL vs. 22.7 ± 7.4 ng / mL, P = 0.048]. Conclusion The changes of plasma tissue factor pathway in patients with atrial fibrillation are characterized by increased coagulation activity and decreased anticoagulant activity. Tissue factor coagulation pathway is involved in the atrial thrombosis mechanism in patients with atrial fibrillation.