射频消融对纤溶系统的影响及缬沙坦的干预作用

The effect of radio frequency catheter ablation to fibrinolysis and the influence of Valsartan.

目的 探讨射频消融 (RFCA)对纤溶系统的影响及缬沙坦对 RFCA术后患者纤溶系统的作用。方法 接受RFCA治疗的患者 14例 ,在插管前、完成电生理标测放电前、放电后、术后 48h及术后 1周 ,对血浆组织型纤溶酶原激活物 (t- PA)和激活抑制物 (PAI- 1)的活性和抗原含量进行系列检测。 7例术后口服缬沙坦 80 mg/ d,连服 7天 ;其他患者作为对照组。结果 各纤溶指标插管前后比较均有显著差异 (P<0 .0 5 )。放电消融前后比较 ,t- PA活性和含量明显降低 ,PAI-1活性和含量均增高 (P<0 .0 5 )。术后 48h与放电前后比较 ,各指标均恢复 (P<0 .0 5 )。术后 1周 ,各指标均恢复到插管前水平 (P>0 .0 5 )。 RFCA术后 1周 ,加用缬沙坦组和对照组比较 ,t- PA活性提高明显 (P<0 .0 5 ) ,PAI- 1活性和含量显著降低 (P<0 .0 5 ) ,而 t- PA含量变化无差异 (P>0 .0 5 )。结论 RFCA可造成纤溶系统的破坏 ,使用缬沙坦有利于 RFCA后纤溶系统的恢复。

Objective Studying the effect of radio frequency catheter ablation (RFCA) to fibrinolysis and evaluating the influence of Valsartan.Methods 14 patients who would receive RFCA were recruited.Plasma tissue plasminogen activator(t PA) and plasminogen activator inhibitor type 1 (PAI 1) antigen and activity were respectively measured before catheterizing,before ablation,after ablation,48 hours and 1 week after operation.7 patients of all received Valsartan 80mg per day after operation.Others made up of the control group.Results The plasma fibrinolytic parameters had significant changes between before and after catheterizing ( P <0.05).Compared with before ablation,t PA antigen and activity after ablation significantly decreased and PAI 1 antigen and activity after ablation increased ( P <0.05),and all parameters in 48 hours after operation had no differences ( P >0.05).1 week after operation,all parameters resumed.Compared with the control group,Valsartan therapy is associated with significant changes in t PA activity( P <0.01),PAI 1 antigen and activity( P <0.05).Conclusion RFCA may destroy fibrinolysis.Valsartan is associated with a significant improvement in plasma fibinolytic parameters after RFCA.