射频消融对血管内皮及血小板功能的影响  

Effect of radiofrequency ablation on endothelial function and platelet activation

作　　者：金争鸣[1] 陈瑶[1] 郑良荣[1] 陶谦明[1] 胡申江[1] 

机构地区：[1]浙江大学医学院附属第一医院,杭州310003

出　　处：《中华内科杂志》2003年第6期400-402,共3页Chinese Journal of Internal Medicine

摘　　要：目的　研究射频导管消融 (RFCA)术对血管内皮和血小板功能的影响。方法　应用放射性免疫法、酶联免疫法、单克隆抗体标记及流式细胞技术 ,观察 31例心动过速患者RFCA手术前、后血浆内皮素 (ET)、血管性假血友病因子 (vWF)水平及血小板α 颗粒膜蛋白 (CD62 P)、血小板溶酶体膜蛋白 (CD63 )表达的变化。结果　RFCA术前、后血浆ET、vWF水平无明显改变 ,但术后即刻血小板膜CD62 P、CD63 表达分别由术前的 (4 .75± 2 .32 ) %和 (9.6 2± 4 .0 8) %增高至 (7.6 4± 5 .2 5 ) % (t =3.0 5 ,P <0 .0 1)和 (12 .2 3± 5 .70 ) % (t=2 .10 ,P <0 .0 5 ) ,术后 4 7～ 115h(平均 6 5h)均降至基础水平。多元相关分析结果显示CD62 P表达变化与累积放电能量呈显著性正相关 (r =0 .30 ,P <0 .0 5 )。结论　RFCA术不引起明显的内皮损伤 ,但可导致血小板膜CD62 P、CD63 表达增加 ,促进血小板活化 ,其中手术累积放电能量是重要的影响因素。Objective To investigate the effect of radiofrequency catheter ablation on endothelialfunction and platelet activation.Methods With radioimmunoassay?enzyme linked immunosorbent assay?cell labeling with monoclonal antibody and flow cytometry technique, thirty-one consecutive patients were checked for levels of plasma endothelin (ET)?von willebrand′s factor (vWF) and expression of platelet α-granule membrane glucoprotein (CD_ 62 P)?platelet lysosome membrane glucoprotien (CD_ 63 ) before,immediatively and 47-115 hours after radiofrequency catheter ablation. Results There was no significant difference in the levels of plasma ET and vWF before and after catheter ablation; The rate of CD_ 62 P and CD_ 63 expression rate on platelets was (4.75±2.32)% and (9.62±4.08)% before catheter ablation, and it significantly increased to (7.64±5.25)% ( t =3.05, P <0.01) and (12.23±5.70)% ( t =2.10, P <0.05) immediately after catheter ablation and then returned to baseline levels 47-115 hours after catheter ablation. There was a positive correlation between the change of CD_ 62 P expression and total energy dose of radiofrequency ( r =0.30, P <0.05). Conclusions Radiofrequency catheter ablation did not bring about significant damage to endothelium but can increase expression of platelet membrance CD_ 62 P,CD_ 63 and promote platelet activation, total energy dose of radiofrequency is one of important influencing factor.

关 键 词：射频消融 血管内皮 RFCA 血小板功能 心动过速 手术治疗 

分 类 号：R541.7[医药卫生—心血管疾病]