Objective To analyze the relation between serum P-selectin and non-paroxysmal atrial fibrillation in coronary atherosclerotic heart disease (CHD) in Ningxia Hui patients.Methods Totally 122 Hui patients with CHD from February 2012 to November 2015 in General Hospital of Ningxia Medical University were enrolled.According to the occurrence of atrial fibrillation,all patients were divided into group A (sinus rhythm,50 cases) and group B (non-paroxysmal atrial fibrillation,72 cases).According to the occurrence of coronary embolization,group B was subdivided into the embolization group (18 cases) and non-embolization group (54 cases).According to New York Heart Association(NYHA) cardiac function classification criteria,group B was subdivided into grade Ⅰ group (12 cases),grade Ⅱ group (20 cases),grade Ⅲ group (18 cases) and grade Ⅳ group (22 cases).Serum P-selectin was tested by enzyme linked immunosorbent assay;serum high-sensitive C-reactive protein(hs-CRP) was tested by immune transmission turbidity method.Levels of P-selectin and hs-CRP were analyzed.Results Serum P-selectin and hs-CRP in group B were significantly higher than those in Group A[(26 ± 8) μg/L vs (18 ± 7) μg/L,(2.4 ± 1.0) mg/L vs (1.2 ± 0.8) mg/L] (P ＜ 0.05).Serum P-selectin and hs-CRP in embolization group were significantly higher than those in non-embolization group [(27 ± 7) μg/L vs (15 ±7) μg/L,(2.8 ± 1.0)mg/L vs (1.3 ±0.7)mg/L] (P ＜0.05).Serum P-selectin and hs-CRP in grade Ⅲ group were significantly higher than those in grade Ⅰ group and grade Ⅱ group[(28 ±4) μg/L vs (18 ±5),(20 ± 8) μg/L;(2.9 ± 0.8) mg/L vs (1.7 ± 0.6),(2.1 ± 0.8) mg/L],serum P-selectin and hs-CRP in grade Ⅳ group [(35 ± 8) μg/L,(3.8 ± 0.7) mg/L] were significantly higher than those in grade Ⅰ,Ⅱ,Ⅲ groups(P ＜ 0.05).In group B,serum levels of P-selectin and hs-CRP showed significant correlation (r =0.587,P ＜ 0.05).Conclusion Elevated serum P-selectin level is related to thromboembolic events and the inflammation condition in Ningxia Hui CHD patients with non-paroxysmal atrial fibrillation.%目的 探讨宁夏回族自治区回族冠状动脉粥样硬化性心脏病(冠心病)患者血清P-选择素水平与非阵发性心房颤动的关系.方法 选取2012年2月至2015年11月在宁夏医科大学总医院住院经临床诊断并行冠状动脉造影检查确诊为冠心病的122例回族患者作为研究对象.根据有无非阵发性心房颤动分为冠心病窦性心律组(A组,50例)和冠心病非阵发性心房颤动组(B组,72例).根据有无栓塞将B组患者分为2个亚组:血栓阳性组(18例)和血栓阴性组(54例).根据纽约心脏病协会(NHYA)心功能分级标准,将B组患者分为4个亚组:Ⅰ级组(12例)、Ⅱ级组(20例)、Ⅲ级组(18例)和Ⅳ级组(22例).采用酶联免疫吸附试验法测定血清P-选择素水平,采用免疫投射比浊法测定高敏C反应蛋白(hs-CRP)水平.比较A组与B组之问、血栓阳性组与血栓阴性组之间、B组不同NHYA心功能分级患者之间的血清P-选择素和hs-CRP水平,分析B组患者血清P-选择素水平与hs-CRP水平的相关性.结果 B组血清P-选择素和hs-CRP水平均明显高于A组[(26±8)μg/L比(18 ±7) μg/L,(2.4±1.0)mg/L比(1.2±0.8)mg/L],差异均有统计学意义(均P＜0.05);血栓阳性组血清P-选择素、hs-CRP水平均明显高于血栓阴性组[(27 ±7)μg/L比(15 ±7) μg/L,(2.8±1.0)mg/L比(1.3±0.7) mg/L],差异均有统计学意义(均P＜0.05);Ⅲ级组血清P-选择素和hs-CRP水平明显高于Ⅰ、Ⅱ级组[(28±4)μg/L比(18±5)、(20 ±8)μg/L;(2.9±0.8)mg/L比(1.7±0.6)、(2.1 ±0.8) mg/L],Ⅳ级组P-选择素、hs-CRP水平[(35±8)μg/L、(3.8±0.7) mg/L]明显高于Ⅰ、Ⅱ、Ⅲ级组,差异均有统计学意义(均P＜0.05).B组患者血清P-选择素水平与hs-CRP水平呈正相关(r=0.587,P ＜0.05).结论 宁夏回族人群血清P-选择素水平升高可预测冠心病非阵发性心房颤动患者的血栓栓塞事件,P-选择素水平变化也可反映冠状动脉粥样病变的炎症情况.
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