血府逐瘀口服液联合阿司匹林对右心导管射频消融所致血栓前状态的影响

Effect of Pretreatment with Xuefuzhuyu Liquor and Aspirin on Prethrombotic state of Radio Frequency Catheter Ablation in Right Ventricle

目的探讨血府逐瘀口服液联合阿司匹林对右心导管射频消融(RFCA)所致血栓前状态的预防作用。方法选择150例行导管射频消融的右侧旁路折返型室上性心动过速(AVRT)病人将其随机分成3组,每组50例,对照组(Ⅰ组)术前不使用血府逐瘀口服液或肠溶阿司匹林;血府逐瘀口服液组(Ⅱ组)术前第7天开始服血府逐瘀口服液10mL,每日3次,术前1d停服;血府逐瘀口服液加阿司匹林组(Ⅲ组)术前第7天开始服血府逐瘀口服液10mL,每日3次,肠溶阿司匹林100mg,每日1次,术前1d停服。每例病人于术前(T0)、电生理检查后即刻(T1)、射频放电全部结束后即刻(T2)、术后24h(T3)检测血浆血小板α颗粒膜糖蛋白(GMP-140)、内皮素(ET)、血管性假血友病因子(vWF)、D-二聚体(DD),并将组内T1,T2,T3时刻与T0时刻比较,组间T1,T2,T3时刻作对比,观察各项指标的变化。结果①组内T1,T2,T3时刻与T0时刻比较,vWF,ET差异均无统计学意义(P>0.05);GMP-140,DD3组均升高,以T2时刻升高最显著,其中Ⅰ组差异有统计学意义(P<0.01),Ⅱ组、Ⅲ组差异无统计学意义(P>0.05)。②组间T1,T2,T3时刻比较,Ⅱ组、Ⅲ组,DD均较Ⅰ组明显降低(P<0.01),Ⅲ组降低幅度较Ⅱ组大但无统计学意义(P>0.05)。结论血府逐瘀口服液加阿司匹林对右心导管射频消融所致血栓前状态有预防作用。

Objective To evaluate the effect of pretreatment with Xuefuzhuyu liquor and aspirin on prethrombotic state of radio frequency catheter ablation （RFCA） in right ventricle. Methods One hundred and fifty patients （pts） with atrioventricular return tachycardia （AVRT） through right path undergoing RFCA were randomized to control group （Group Ⅰ） without Xuefuzhuyu liquor and aspirin （ n = 50） before RFCA; pretrcatment group（Group Ⅱ ） with Xuefuzhuyu liquor（ n = 50） for 7 days prior to RFCA; pretreatment group（Group Ⅲ） with Xuefuzhuyu liquor and aspirin （n = 50）. vWF, ET, GMP- 140 and D- dimer levels of plasma were measured at four different time points：before RFCA（T0）,immediately after the electrophysiological studies（EPS）（T1 ）, immediately after the last RFCA（T2） and at 24 hours after RFCA（T3）. The changes within groups at T1, T2, T3 with To and the differences between groups at T1, T2, T3 were compared. Results ①It was no remarkable difference that the both levels of plasma vWF and ET at T1 ,T2,T3 compared with its at T0（P〈0.05） within every group, respectively. There were no remarkable differences at T1, T2, T3 for the both levels of plasma vWF and ET between every group （P〈0.05）, respectively. ②The both levels of plasma GMP- 140 and DD were higher at T1 ,T2 ,T3 than that at To within every group, respectively. The peak of values appeared at T2（P〈0.01）. The changes of both levels of plasma GMP- 140 and DD were significant in control group （P 〈 0.05 or P 〈 0.01 ）, but it were insignificant in other both groups （P 〈 0.05）. ③The both levels of plasma GMP - 140 and DD were lower in Group Ⅱ and Ⅲ than that in control group （P 〈 0.05 or P 〈 0.01 ） and that were the lowest in Group Ⅲ. Conclusion Pretrcatment with Xuefuzhuyu liquor and aspirin could prevent prethrombotic state of RFCA in right ventricle.