永久性心脏起搏对纤溶系统的影响  

Effect of permanent cardiac pacing on fibrinolytic system

作　　者：黄波[1] 朱福[1] 胡春燕[1] 蒋庆渊[1] 李锦玉[1] 陆铭[1] 

机构地区：[1]上海市南汇区中心医院心血管内科

出　　处：《中国心血管病研究》2005年第8期606-609,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨不同模式永久性心脏起搏对纤溶系统的影响。方法随机选择安装永久性心脏起搏器患者54例,根据起搏模式分为两组,其中VVI起搏器36例(V组),DDD起搏器18例(D组)。选择32例起搏器术前患者作对照组(C组)。测定组织型纤溶酶原激活剂(t-PA)活性、a2-纤溶酶抑制剂(a2-PI)活性、纤溶酶原灭活剂(PAI)活性及D-二聚体(D-D)浓度。结果V组和D组的PAI活性明显高于C组(P<0.01),V组和D组之间差异也有统计学意义(P<0.05)。V组和D组的t-PA活性却明显低于C组(P<0.01),其中V组又低于D组(P<0.05)。PAI/t-PA比值的改变与PAI活性改变相似;PAI/t-PA比值与术后时间之间没有线性相关关系(P>0.05)。V组的a2-PI活性高于C组(P<0.05)。各组之间D-D浓度差异无统计学意义(P>0.05)。结论置入永久性心脏起搏器患者纤溶功能处于低下状态,尤其以单腔心室起搏为明显。Objective To investigate the effect of different model permanent pacemaker on fibrinolytic system. Methods 54 consecutive permanent cardiac pacing cases were randomly divided into two groups according to the pacing model. There were 36 patients with VVI pacemaker （group V） and 18 cases with DDD pacemaker （group D）. 32 preoperative patients were selected as controls （group C ）. Plasma tissue plasminogen activator （t-PA） activity, a2-plasmin inhibitor （a2-PI） activity, plasminogen activator inhibitor （PAI） activity and concentration of D-dimer were measured. Results PAI activity in group V and D was significantly higher than that in group C （P〈0.01）. It was also different between group V and group D （P〈0.05）. However, t-PA activity in group V and D was significantly lower than that in group C （P〈0.01）. The t-PA activity decreased signicantiy in group V compared with group D （P〈0.05）. The change of PAl ： t-PA ratio was similar to the change of PAI activity. There were not linear correlation between the PAI ：t -PA ratio and the time of postoperation （P〉0.05）. The a2-PI activity in group V was higher than that in group C （P〈0.05）. Concentration of D-Dimer was not significant different between any group（P〉0.05 ）. Conclusion The fibrinolytic function in patients with permanent pacemaker is low especially in single-chamber ventricular pacing patients.

关 键 词：心脏起搏器 人工 纤维蛋白溶解 纤溶酶原灭活剂 纤溶酶 

分 类 号：R318.11[医药卫生—生物医学工程]