射频消蚀术前后血清心肌酶变化的研究

The variation of serum myocardial enzyme levels after radiofrequency current ablation

对３３例患者射频消蚀术（简称ＲＦＣＡ）前后的血清心肌酶（ＣＫ、ＣＫ－ＭＢ．ＡＳＴ、ＬＤＨ、ＬＤＨ１）进行动态观察。结果表明：ＲＦＣＡ后血清心肌酶活性均有不同程度的升高（Ｐ＜０．０１）；ＣＫ及ＣＫ－ＭＢ于术后６小时达到峰值，２４小时恢复至正常水平，ＡＳＴ于术后１２小时达峰值、时达峰值，７２小时恢复正常，ＬＤＨ及ＬＤＨ，的达峰及恢复时间分别为２４小时和１２０小时；多元线性相关分析显示心肌酶活性的升高程度与消蚀靶点个数呈高度正相关（ｒ＝０．８１３６，Ｐ＜０．００１）．揭示ＲＦＣＡ对心肌组织有不同程度的损伤，影响心肌损伤范围的主要因素是消蚀靶点的多少。因此，在ＲＦＣＡ中，应力求标测定位准确，尽量减少试探性放电，以最大限度地减少心肌损伤。

Serum myocardial enzyme activities (CK, CK-MB, AST, LDH and LDH1) were serially determined in 33 patients who underwent radiofrequency current ablation (RFCA). These enzyme levels all increased in various degrees after RFCA (P<0.01),which meant RFCA could damage myocardial tissues small and large. Mean enzyme level increased to a maximum after operation: 6h, CK and CK-MB, 12h; AST; 24h,,LDH and LDH1 and normalization occurred within 24h, 72h and 120h,respetively The variation of CK-MB activity correlated with radiofrequency ablation sites (r=0. 8136,P<0. 001), which indicated the damage range was crucially affected by radiofrequency ablation sites. Consequently,to limit myocardial lesion in patients who undergo the precedure; it is very important to precisely locate ablated position to reduce radiofrequency ablation sites.