射频损伤与血凝状态改变的观察

Observation on the Changes of the Blood Coagulable States During and After Radiofrequency Catheter Ablation

目的 通过对 RFCA术中术后 DD浓度及 GMP- 140表达变化的观察 ,来研究 RFCA对血凝状态的影响。方法 对连续 32例接受 RFCA治疗的病人 ,在插管前、电生理标测完成 ,放电前、放电后及术后 40～ 48h,动态测定血浆 DD浓度及 GMP- 140阳性表达活化血小板百分率。结果 平均血浆DD浓度及活化血小板百分率 ,在插管前分别为 :5 5 8± 2 85 ,1.6 5 2± 0 .918;电生理标测后为 :984± 5 2 6 ,3.12 1± 2 .76 5 ;放电后为 :1879± 892 ,4.135± 3.6 0 9;术后 40～ 48h分别为 :90 7± 491,4.2 43± 3.5 96。各组与基线值比较 ,均明显增高。结论 RFCA术中术后血浆 DD浓度增高 ;GMP- 140表达增加 ,RFCA造成血凝状态改变。

Objective To investigate whether the application of radiofrequency energy might activate endogenous thrombotic mechanisms and platelets,whether radiofrequency catheter ablation(RFCA) might result in changes of the blood coagulable states.Methods We made serial determinations of plasma D-dimer level by enzyme immunoassay and the percentage of activated platelet with positive exepression of GMP-140 by flow cytomety before insertion of catheters,after completion of electrophysiologic study(EPS) but before RFCA,immediately after RFCA,and 40～48h after RFCA in 32 consecutive patients undergoing RFCA.Results The mean D-dimer level was 558±285(μg/L);984±526;1879±892;907±491,respectively.The mean percentage of activated platelet with positive exepression of GMP-140 was 1 652±0 918(%);3 121±2 765;4 135±3 609;5 243±3 596,respectively.Conclusions As reflected by elevated plasma D-dimer level and platelet-activated percentage.RFCA might result in changes of the blood coagulable states.