摘要
目的通过观察超声与射频环状消融上、下腔静脉口对心肌损伤的影响,探讨其临床应用价值。方法分别于消融前,消融后即刻、2 hr、8 hr、24 hr、48 hr及72 hr抽取静脉血3 ml,测定CK、CK-MB及cTnT。结果超声消融组的手术操作时间、暴光时间均小于射频组(25±13 min vs72±18 min,P<0．01;8±3 min vs 26±11 min,P<0．01),且容易达到消融终点(电隔离);超声消融与射频消融后,两组CK、CK-MB及cTnT均升高,但超声组低于射频组(峰组分别为1162．4 U／L vs 1697 U／L,215．8 U／L vs393．6 U／L,0．55 ng／ml vs 0．766 ng/ml;P均<0．05);在检测心肌损伤中,cTnT由现的时间早于CK、CK-MB,升高的程度高于CK、CK-MB。结论超声消融静脉口与射频环状消融相比,手术操作简单,容易达到消融终点,且对心肌损伤小;cTnT在检测导管消融中心肌损伤的敏感性高于CK及CK-MB。
Objective To investigate the degree of myocardial injury incurred by ultrasound ablation and radiofrequency linear ablation of vena cava（VC） orifice and explore their clinical valuation. Methods 5 mongel dogs＇ vena cava orifice received ultrasound ablation,another 6 received radiofrequency linear ablation. Level of creatine kinate（CK） .CK-MB and cardiac troponin T（cTnT） were determined before the procedure, right after completion of the ablation and 2,8,24,48,72 hour afterwards. Result The average time to finish ultrasound ablation of VC and the time exposing to X ray were less than radiofrequency ablation （25±13 min vs 72±18 min,8±3 min vs 6±11 min; P〈0.01 ）, and more easy to reach electrical isolation in ultrasound ablation group; peak values of all parameters of radiofrequency ablation were significantly highter than ultrasound abla tion（CK：1697U/L vs 1162.4U/L,CK-MB：393.6 U/L vs 215.8 U/L,cTnT：0. 766 ng/ml vs 0.55 ng/ml; P〈0.05 ） ; the peak values of cTnT is higher and early than CK and CK-MB. Conclusion Ultrasound ablation is a quite feasible approach in reaching electrical isolation at veins orifice and cause less injury than radiofrequency linear ablation.
出处
《青岛医药卫生》
2005年第6期411-414,共4页
Qingdao Medical Journal
