儿童房间隔缺损介入术前后凝血机能的变化  

Alterations in coagulation in children with atrial septal defect before and after treatment with transcatheter closure

作　　者：刘倩[1] 覃军[2] 易岂建[1] 李谧[1] 吕铁伟[1] 刘晓燕[1] 蒲晓芳[1] 计晓娟[1] 白永红[1] 瞿平[1] 

机构地区：[1]重庆医科大学附属儿童医院心脏中心 儿童发育疾病研究省部共建教育部重点实验室 儿科学重庆市重点实验室 重庆市(儿童发育重大疾病诊治与预防)国际科技合作基地,400014 [2]第三军医大学新桥医院心内科

出　　处：《中国介入心脏病学杂志》2012年第3期137-140,共4页Chinese Journal of Interventional Cardiology

基　　金：重庆市科委重点项目(CSTC2009AB5033)

摘　　要：目的探讨儿童房间隔缺损(ASD)介入治疗封堵器植入前后凝血机能的变化及ASD介入治疗的安全性。方法采用酶联免疫吸附法(ELISA)检测19例儿童ASD患者介入封堵前后血浆凝血酶原片段1+2(F1+2)、β-血小板球蛋白(β-TG)、血浆组织型纤溶酶原激活物(t-PA)、D二聚体(D-dimer)浓度。结果与封堵术前比较,血浆F1+2、t-PA、D-dimer浓度术后即刻明显升高,术后1日较术前水平仍高,但差异无统计学意义,术后1个月基本恢复至术前水平;β-TG术后即刻明显升高,术后1天基本恢复至术前水平。结论儿童ASD介入封堵术后出现了凝血酶、纤溶系统的激活及血小板的活化,短期内恢复至术前水平;儿童ASD介入术后使用阿司匹林抗凝已足够;介入治疗ASD安全、有效。Objective To investigate the changes in coagulation in children with atrial septal defect （ASD） after transcatheter closure and the safety of interventional treatment in ASD. Methods Serum levels of prothrombin fragmentl ＋ 2 （ F1 ＋ 2 ）,β-thromboglobulin （ β-TG ）, tissue-type plasmingen activator （ t- PA）, D-dimer were measured by enzyme linked immnnosorbent assays （ELISA） before and after transeatheter closure. Results Compared with the results of pre-occlusion, the levels of serum F1 ＋ 2, t- PA, D-dimer raised by the end of the closure procedure （ P 〈 0. 05 ） , and the levels remained higher than pre-oeclusion level till 24 hrs post procedure but with no statistic difference（ P 〉 0.05 ）. The levels gradually returned to the baseline levels 1 months after occlusion. β-TG levels also raised by the end of the closure procedure （P 〈 0. 05 ）, and returned to the baseline level at 24 hour after closure. Conclusions The function of coagulation is activated in early and recovered in a short time after transcatheter closure in children with ASD; Aspirin is enough to anticoagulant after oeeluder theraphy in children with ASD. Interventiona] treatment in children with ASD is safety and effective.

关 键 词：房间隔缺损 心脏导管插入术 血液凝固因子 

分 类 号：R735.7[医药卫生—肿瘤]