摘要
目的 观察射频导管消融术 (RFCA)对凝血物质的影响 ,以及术后的恢复时间。方法 对连续 6 0例接受RFCA术的患者 ,在RFCA术中穿刺血管之前、心内电生理检查之后、成功消融放电即刻、术后第 2d和第 7d ,抽取静脉血标本 ,采用ELISA法测定血浆中的凝血物质 :D 二聚体 (D dimer)、血小板α 颗粒膜糖蛋白 (plateletα granulemembraneglucoprotein ,GMP 14 0 )、内皮细胞损伤的分子标志物 (血管内假友病因子 ,vonwillebrand’sfactor,VWF)水平。结果 与穿刺血管之前相比较 ,血浆中D 二聚体 ,GMP 14 0和VWF浓度在心内电生理检查之后、消融放电即刻和术后第 2d均显著性升高 (P <0 0 5或P <0 0 1) ,并于第 7d降至穿刺血管之前的水平 (P >0 0 5 )。其中 ,D 二聚体和VWF的浓度在消融放电即刻达到高峰 ,分别是穿刺血管前浓度的 6 0倍和 2 2倍 ;而GMP 14 0的浓度在术后第 2d增至峰值 ,为穿刺血管前浓度的 2倍。结论 RFCA术可以引起血浆中凝血物质水平的显著增加 ,直接影响血凝状态。术中及术后监测D 二聚体、GMP 14 0和VWF浓度 。
Objective To observe the changes of the blood coaguable states due to radiofrequency catheter ablation(RFCA)and the restoring time of the levels of the blood coaguable substances after RFCA.Methods The plasma levels of D dimer,platelet α granule membrane glucoprotein(GMP 140),von Willebrand's factor(VWF)were assayed in 60 consecutive patients undergoing RFCA by Enzyme linked Immuno Sorbent Assay(ELISA).Blood samples were obtained by inserting veins before RFCA was performed,after electrophysiologic(EP)study was finished,just at the time that RFCA was accomplished,the second day and the seventh day after RFCA.Results The plasma levels of D dimer,GMP 140,VWF increased distinctly when EP study was finished,just the time RFCA was performed,and the second day after RFCA( P <0 05 or P <0 01),and restored in the seventh day after RFCA( P >0 05),contrasted to the levels of those before RFCA was performed.And the peak levels of D dimer and VWF were presented just at the time RFCA was performed,which were 6 times and 2 2 times the initial ones respectively.While the peak level of GMP 140 was presented in the second day after RFCA,which was 2 times the initial one.Conclusion RFCA may change the blood coaguable states by increasing the levels of the blood coaguable substances.Monitoring the plasma levels of D dimer,GMP 140,VWF is valuable in guiding the administration of anticoagulative drugs and prophylaxis of thromboembolic events.
出处
《中华心律失常学杂志》
2002年第5期273-275,共3页
Chinese Journal of Cardiac Arrhythmias
