Hasan-Ali Hosam, Mosad Eman
Department of Cardiovascular Medicine, Assiut University Hospitals, Assiut, Egypt.
Department of Clinical Pathology, Assiut University Hospitals, Assiut, Egypt
Clin Appl Thromb Hemost. 2015 May;21(4):339-47. doi: 10.1177/1076029614533144. Epub 2014 May 19.
Markers of platelet activity (P-selectin), fibrinolysis (d-dimer), thrombin activity (prothrombin fragments 1, 2 [PF1,2] and thrombin-antithrombin III complex [TAT]), and inflammation (interleukin 1β [IL-1β]) were measured in 65 patients with mitral stenosis (MS) before and 2 weeks after percutaneous mitral valvotomy (PMV) and in 23 controls. All markers were significantly higher than the control and significantly decreased after PMV. P-selectin change correlated with the changes in left atrial diameter (LAD), pulmonary artery systolic pressure (PASP), and IL-1β. d-Dimer change had similar correlations, LAD, PASP, and IL-1β. The PF1,2 change correlated with the change in IL-1β. The TAT change correlated with the changes in LAD. The IL-1β change correlated with the changes in PASP. In conclusion, MS is associated with heightened inflammatory, platelet, thrombin, and fibrinolytic activities that decrease after PMV. Altered hemodynamics and reduced inflammatory activity might have a possible role in these changes.
在65例二尖瓣狭窄（MS）患者经皮二尖瓣球囊成形术（PMV）前及术后2周，以及23例对照者中，检测了血小板活性标志物（P选择素）、纤维蛋白溶解标志物（D - 二聚体）、凝血酶活性标志物（凝血酶原片段1、2 [PF1,2]和凝血酶 - 抗凝血酶III复合物[TAT]）以及炎症标志物（白细胞介素1β [IL - 1β]）。所有标志物均显著高于对照组，且在PMV后显著降低。P选择素的变化与左心房直径（LAD）、肺动脉收缩压（PASP）及IL - 1β的变化相关。D - 二聚体的变化与LAD、PASP及IL - 1β有类似的相关性。PF1,2的变化与IL - 1β的变化相关。TAT的变化与LAD的变化相关。IL - 1β的变化与PASP的变化相关。总之，MS与炎症、血小板、凝血酶及纤维蛋白溶解活性增强相关，这些活性在PMV后降低。血流动力学改变和炎症活性降低可能在这些变化中起作用。
