Büyükaşik Y, Ileri M, Ozcebe O I, Haznedaroglu I C, Yetkin E, Kirazli S, Korkmaz S, Dündar S V
Department of Hematology, Hacettepe University Medical School, Ankara, Turkey.
Blood Coagul Fibrinolysis. 1999 Oct;10(7):417-21. doi: 10.1097/00001721-199910000-00003.
In this study, we aimed to determine systemic coagulation activity in patients with rheumatic mitral stenosis and to define determinants of a possible prethrombotic state. Peripheral venous plasma level of thrombin-antithrombin III complex was measured in 84 consecutive patients with rheumatic mitral stenosis who had no left atrial thrombus by transesophageal echocardiography. The patients had significantly higher thrombin-antithrombin III complex values (mean +/- SD = 9.6+/-15.9 ng/ ml) compared with the healthy subjects (2.1+/-1.8 ng/ml) (P<0.001). Among many clinical and echocardiographic variables, severe mitral regurgitation (odds ratio = 6.7, P<0.001) and left atrial spontaneous echo contrast (odds ratio = 22.8, P<0.001) appeared as significant predictors of the increased systemic coagulation activity in multivariate logistic regression analysis. In conclusion, systemic coagulation activity is increased in the patients with rheumatic mitral stenosis, and coexistence of severe mitral regurgitation and presence of left atrial spontaneous echo contrast are determinants of this increment.
在本研究中，我们旨在确定风湿性二尖瓣狭窄患者的全身凝血活性，并明确可能的血栓前状态的决定因素。通过经食管超声心动图对84例连续的无左心房血栓的风湿性二尖瓣狭窄患者测定外周静脉血浆凝血酶 - 抗凝血酶III复合物水平。与健康受试者（2.1±1.8 ng/ml）相比，患者的凝血酶 - 抗凝血酶III复合物值显著更高（均值±标准差 = 9.6±15.9 ng/ml）（P<0.001）。在众多临床和超声心动图变量中，重度二尖瓣反流（比值比 = 6.7，P<0.001）和左心房自发显影（比值比 = 22.8，P<0.001）在多因素逻辑回归分析中表现为全身凝血活性增加的显著预测因素。总之，风湿性二尖瓣狭窄患者的全身凝血活性增加，重度二尖瓣反流的并存以及左心房自发显影的存在是这种增加的决定因素。
