射频消融术前后血栓前状态标志物的变化  

Radiofrequency catheter ablation and prethrombotic state

作　　者：刘红[1] 刘凡[2] 王秉臣[2] 

机构地区：[1]河北工程大学附院心内科,河北邯郸056029 [2]河北医科大学心内科

出　　处：《临床心血管病杂志》2006年第11期662-664,共3页Journal of Clinical Cardiology

摘　　要：目的:通过测定接受导管射频消融术(RFCA)的患者其血栓前状态敏感标志物CD62P、Ⅱb/Ⅲa、凝血酶原时间(PT)、血浆凝血因子Ⅰ(FIB)水平的改变,探讨RFCA与血栓前状态的关系及相应的干预措施,以便减少RFCA后血栓并发症的出现。方法:设健康对照组20例。接受RFCA治疗的67例房室结折返性心动过速患者(RFCA组)随机分为2亚组,其中肝素亚组为29例,非肝素亚组38例。2亚组共采静脉血5次:静脉鞘置入即刻①、心内电生理检查后②、射频消融完成即刻③、术后24h④、术后48h⑤;①、②、③、④、⑤时间点检测CD62P、Ⅱb/Ⅲa,在①、④时间点检测PT、血浆FIB水平。结果:实验组CD62P、Ⅱb/Ⅲa在RFCA后即刻与术前比较有显著性增高(P<0.05);术后24h接近术前水平(P>0.05),仍高于对照组(P<0.05),术后48h与对照组比较差异无统计学意义(P>0.05)。肝素亚组与非肝素亚组CD62P、Ⅱb/Ⅲa在术前、术后比较差异无统计学意义(P>0.05);PT、血浆FIB水平术后24h与术前比较差异无统计学意义(P>0.05)。结论:RFCA可引起血栓前状态,肝素亚组与非肝亚素组血小板活化表达差异无统计学意义。PT、FIB不如CD62P、Ⅱb/Ⅲa敏感。Objective：To investigate whether the application of radiofrequency catheter ablation （RFCA） might induce a prethrombotic state, we study the biochemicalmarkers of prethrombotic state ,including platelet membrane protein CD62P, Ⅱb/Ⅲa, prothrombin （PT） and fibrinogen（FIB） before and after RFCA. Method.. Sixty-seven patients with supraventricular tachycardia were enrolled in the study. Serial determinations of the percentage of actived platelets CD62P and Ⅱb/Ⅲa were made at the time insertion of venious sheaths and before the catheter insert （ Ⅰ ） ,after electrophysiologic study（EPS）（ Ⅱ ） ,immediately after RFCA（ Ⅲ ）, 24 hours after RFCA（ Ⅳ ）, after 48 hours （ Ⅴ ） by flow cytometry. The plasma levels of PT and FIB were measured at the time point Ⅰ , Ⅳ with the means of ACL. Heparin was given during the operation by artery accessory pathways. Result： Compared with the baseline, the percentage of activated platelets CD62P and Ⅱb/Ⅲa increased significantly at the end of RFCA （ P 〈0.05）, and no significance between with heparin and no-heparin. There were no significance between the levels of PT and FIB at the time point Ⅰ , Ⅳ （ P 〉0.05）. Conclusion.. The procedure of radiofrequency catheter ablation can induce a prethrombotic state.

关 键 词：射频消融术 血栓前状态 凝血酶原时间 血浆FIB水平 血小板膜糖蛋白CD62P Ⅱb/Ⅲa 

分 类 号：R544.1[医药卫生—心血管疾病]