目的：通过检测窦性心律的慢性心力衰竭患者血浆中 D －二聚体、P －选择素和 B 型钠尿肽（BNP）的水平，探索窦性心律心力衰竭患者抗凝、抗栓治疗的必要性及治疗的时机。方法选取窦性心律慢性心力衰竭患者68例。根据射血分数（EF）进行分组：A 组 EF≥45％，20例；B 组45％＞EF ＞35％，22例；C组 EF≤35％，26例。分别测定血浆 D －二聚体、P －选择素、BNP 水平。结果C 组患者血浆 D －二聚体[（4．7±2．79）μg／mL 比（3．01±1．15）μg／mL]、P －选择素[（17．2±2．4）μg／L 比（14．6±3．7）μg／L]、BNP [（1347．8±158．4）μg／L 比（478．9±26．0）μg／L]明显高于 B 组，B 组患者血浆 D －二聚体、P －选择素、BNP 明显高于 A 组[（3．01±1．15）μg／mL 比（2．15±0．28）μg／mL，（14．6±3．7）μg／L 比（10．9±2．5）μg／L，（478．9±26．0）μg／L 比（264．5±27．1）μg／L]，差异有统计学意义（P ＜0．05）。结论在窦性心律的心力衰竭患者中，发现 BNP 升高与 D －二聚体，P －选择素升高成正相关。%Objective To explore the necessity and the optimal time of anticoagulant and antithrombotic thr-erapy by detecting the level of D-dimer,P-selectin and BNP in the heart failure patients with sinus rhythm.Methods 68 patietns with heart failure and sinus rhythm were randomly divided into three groups according to the EF(Group A:who′EF value was greater than 45%,20 cases;Group B:who′EF value was greater than35% and lower than 45%, 22cases;Group C:who′EF was lower than 35%,26 cases),the concentration of D-dimer,P-selectin and BNP were measured.Results The concentration of plasma D-dimer,P-selectin and BNP in group C were significantly higher than those in group B and group A(P <0.05).Conclusion The increase level of BNP is positive related with D-di-mer and P-selectin for Sinus rhythm in patients with heart failure.
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