Minamino T, Kitakaze M, Sato H, Asanuma H, Funaya H, Koretsune Y, Hori M
First Department of Medicine, Osaka University School of Medicine, Japan.
Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):3191-5. doi: 10.1161/01.atv.17.11.3191.
Patients with atrial fibrillation have been reported to exhibit abnormal hemostasis. Since nitric oxide (NO) exerts antithrombotic effects and attenuates platelet function, we evaluated two indicators of plasma NO levels, the plasma levels of nitrite and nitrate (NOx), and the levels of cGMP in platelets. We also examined whether indicators of plasma NO levels were associated with abnormalities in parameters related to platelet function, blood coagulation, and fibrinolysis. We evaluated 45 patients with chronic sustained atrial fibrillation (33 men and 12 women, age range 63 +/- 2 years) compared with 45 sex- and age- (+/- 2 years) matched nonhospitalized subjects with sinus rhythm. There were no significant differences between the two groups in the incidence of risk factors for stroke except for ischemic heart disease or in echocardiographic parameters. Plasma levels of NOx measured using the Greiss reagent (mean [interquartile range]: 15.6 [9.5 to 25.7] versus 24.1 [14.2 to 40.8] mumol/L, n = 45) and the platelet cGMP levels (0.33 [0.16 to 0.67] versus 0.63 [0.31 to 1.29] pmol/10(9) platelets, n = 9) were significantly (P < .05) lower in the patients with atrial fibrillation than in the control subjects. Plasma levels of D-dimer, beta-thromboglobulin, and fibrinogen were significantly (P < .05) higher in the patients with atrial fibrillation. The two groups did not differ as to the plasma levels of tissue plasminogen activator or plasminogen activator inhibitor-1. Our findings suggest that a decrease in plasma NO levels may account for the hemostatic abnormalities observed in patients with atrial fibrillation.
据报道，房颤患者存在异常止血情况。由于一氧化氮（NO）具有抗血栓作用并能减弱血小板功能，我们评估了血浆NO水平的两个指标，即亚硝酸盐和硝酸盐（NOx）的血浆水平以及血小板中cGMP的水平。我们还研究了血浆NO水平指标是否与血小板功能、血液凝固和纤维蛋白溶解相关参数的异常有关。我们评估了45例慢性持续性房颤患者（33例男性和12例女性，年龄范围63±2岁），并与45例年龄和性别匹配（±2岁）的非住院窦性心律受试者进行比较。除缺血性心脏病外，两组在中风危险因素发生率或超声心动图参数方面无显著差异。使用格里斯试剂测量的血浆NOx水平（平均值[四分位间距]：15.6[9.5至25.7]对24.1[14.2至40.8]μmol/L，n = 45）和血小板cGMP水平（0.33[0.16至0.67]对0.63[0.31至1.29]pmol/10⁹血小板，n = 9）在房颤患者中显著（P <.05）低于对照组。房颤患者的D - 二聚体、β - 血小板球蛋白和纤维蛋白原血浆水平显著（P <.05）更高。两组在组织纤溶酶原激活物或纤溶酶原激活物抑制剂 - 1的血浆水平方面无差异。我们的研究结果表明，血浆NO水平降低可能是房颤患者观察到的止血异常的原因。
