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目的观察不同抗栓方式对非瓣膜性心房颤动(NVAF)患者血浆溶血磷脂酸(LPA)含量变化的影响,为临床进行抗栓治疗提供依据。方法235例未接受抗栓治疗的NVAF患者,随机分为阿司匹林/双嘧达莫治疗组(A组)、阿司匹林/固定剂量华法林治疗组(B组)及适宜剂量华法林治疗组(C组)。测定治疗前、治疗后2周和6周血浆LPA含量,分析各年龄亚组的变化并进行疗效比较。结果B组在2周和6周后血浆LPA含量的降低幅度均显著大于其他两组。A组中<60岁年龄亚组血浆LPA在2周和6周后均较治疗前显著降低,其他两个年龄亚组治疗前后无显著变化;B组的<60岁和60~75岁年龄亚组的血浆LPA含量在2周和6周后均较治疗前显著降低,>75岁年龄组在治疗前后则无显著变化;C组各年龄亚组的血浆LPA含量在2周和6周后均较治疗前显著降低。结论不同抗栓治疗方式对不同年龄段NVAF患者体内血小板活化有不同影响。小于60岁者可给予阿司匹林联合双嘧达莫治疗,60~75岁的患者可给予阿司匹林联合固定剂量华法林治疗,大于75岁的患者推荐应用适宜剂量的华法林(INR1·5~2·1)治疗。
Objective To observe the effect of different antithrombotic therapy on plasma lysophosphatidic acid (LPA) content in patients with non-valvular atrial fibrillation (NVAF) and provide the basis for clinical antithrombotic therapy. Methods A total of 235 NVAF patients without antithrombotic therapy were randomly divided into two groups: aspirin / dipyridamole treatment group (A group), aspirin / fixed-dose warfarin treatment group (B group) and appropriate dose of warfarin treatment group Group C). Plasma LPA levels were measured before treatment, 2 weeks and 6 weeks after treatment, and the changes in subgroups of all ages were analyzed and compared. Results After 2 and 6 weeks, the plasma LPA level in group B decreased significantly more than the other two groups. Plasma LPA in subgroup <60 years old in group A was significantly lower than that before treatment in subgroup <60 years old, and no significant changes in other two subgroups before and after treatment in subgroup <60 years; in subgroup <60 years and 60-75 years in subgroup B Plasma LPA levels were significantly lower at 2 weeks and 6 weeks than those before treatment, but no changes were found in> 75-year-old group before and after treatment. Plasma LPA levels were significantly decreased in all subgroups of group C at 2 and 6 weeks after treatment. Conclusion Different antithrombotic therapy have different effects on platelet activation in patients with NVAF at different ages. Aspirin and dipyridamole may be given to those under 60 years of age. Patients 60 to 75 years of age may receive aspirin combined with a fixed-dose warfarin therapy. Patients over 75 years of age are recommended to receive appropriate doses of warfarin (INR 1.5-2 · 1) Treatment.