Sohara H, Miyahara K
Division of Cardiology, Shinkyo Hospital, Kagoshima, Japan.
Jpn Circ J. 1994 Nov;58(11):821-6. doi: 10.1253/jcj.58.821.
To clarify the effect of atrial fibrillation (AF) on the fibrino-coagulation system, fibrino-coagulation parameters in the paroxysmal period of AF were determined in 13 patients with paroxysmal atrial fibrillation (PAF) and compared with those in the non-paroxysmal period of AF, and with those in normal subjects. Estimated titers of hemoglobin and hematocrit in the paroxysmal period of AF were significantly higher than those in the non-paroxysmal period and also higher than those in normal subjects. The activated partial thromboplastin time in the paroxysmal period was also longer than that in the non-paroxysmal period of AF or in normal subjects. However, other estimated parameters, such as prothrombin time, fibrinogen, thrombin-antithrombin III, beta-thromboglobulin, platelet factor 4, D-dimer and plasmin inhibitor complex, did not show any significant deviation. These results conflict with those of previous reports which indicated that the fibrino-coagulation system was enhanced in cases of chronic AF. Our results suggest that there is no significant activation of the fibrino-coagulation system, except for obvious hemoconcentration, within the first few hours after the onset of PAF. Thus, in terms of the properties of blood coagulation, thromboembolism is preventable if antiarrhythmic therapy is administered within several hours after the onset of PAF.
为阐明心房颤动（AF）对纤维蛋白-凝血系统的影响，对13例阵发性心房颤动（PAF）患者在AF发作期的纤维蛋白-凝血参数进行了测定，并与AF非发作期患者及正常受试者的参数进行比较。AF发作期血红蛋白和血细胞比容的估计值显著高于非发作期，也高于正常受试者。发作期活化部分凝血活酶时间也长于AF非发作期或正常受试者。然而，其他估计参数，如凝血酶原时间、纤维蛋白原、凝血酶-抗凝血酶III、β-血小板球蛋白、血小板因子4、D-二聚体和纤溶酶抑制剂复合物，均未显示出任何显著差异。这些结果与先前报道的慢性AF病例中纤维蛋白-凝血系统增强的结果相矛盾。我们的结果表明，在PAF发作后的最初几个小时内，除明显的血液浓缩外，纤维蛋白-凝血系统无显著激活。因此，就凝血特性而言，如果在PAF发作后数小时内给予抗心律失常治疗，血栓栓塞是可预防的。
