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目的:研究心房纤颤患者血栓前状态分子标志物vWF及凝血酶一抗凝血酶Ⅲ复合物(TAT)水平,D-二聚体(D-D)及P-选择素(GMP-140)水平与发生血栓栓塞事件的危险性研究.方法:采集初发非瓣膜性心房纤颤的患者,测定其体内的血栓前状态分子标志物vWF及凝血酶一抗凝血酶Ⅲ复合物(TAT)水平, D-二聚体(D-D)及P-选择素(GMP-140)水平,随诊720天观察这些患者发生血栓栓塞事件的频率.把发生血栓栓塞事件的患者分为A组,没有发生血栓栓塞事件的分为B组,对比两组的血管性假血友病因子(vWF),血浆凝血酶-抗凝血酶复合物(TAT),D-二聚体(D-D)及P-选择素(GMP-140)水平,进行单因素分析;对血栓栓塞事件进行Logistic 多因素回归分析.结果:两组的基本资料比较差异无统计学意义(P>0.05),A组的vWF、TAT、D-D水平,与B组比较均明显高,差异有统计学意义(P0.05).结论:房颤患者血栓栓塞的独立危险因素是vWF、TAT、D-D浓度增高,且D-D 浓度增高的危险因素高于其他因素,结合多个危险因素,可提高诊断房颤血栓栓塞的特异性,更可靠地分析血栓栓塞危险性.“,”Objective:To explore the level of von Wilebrand factor (VWF),thrombin-antithrombin complex(TAT),D-dimer(DD),and P-selectin(GMP-140) to evaluating the risk for thromboembolism events in patients with nonvalvular atrial fibrilation. Methods:Test the level of von Wilebrand-factor(VWF),thrombin-antithrombin-complex(TAT),D-dimer(DD),and P-selectin(GMP-140) of patients with nonvalvular atrial fibrilation. Folowing up al patients for 720 days ,then divided into thromboembolism events group (A) and nonthromboembolism events group (B). The level of VWF,TAT,DD and GMP-140 were statisticaly analyzed between A and B. Results: No significant changes of basic record were found between the two groups(P>0.05) , but the level of vWF、TAT、D-D of group A had significantly higher levels compared with group B(P0.05). Conclusion: The left atrial dimension, timing of fibrilatory waveand Ddimer have certain clinical value to evaluating the risk for thromboembolism events with nonvalvular atrial fibrilation,and the diagnostic specificity and positive predictive value of the multivariate analysis are higher than those of the single factor.