摘要
目的：通过动态观察射频消融术患者心肌酶及 肌钙 蛋白Ⅰ（ｃＴｎＩ）的变化，评价射频消融术对心肌的损伤及其影响因素。方法：射频消融术组４０ 例，男２４例，女１６例，年龄９～７３岁，均无器质性心脏病，其中左侧旁道１８例，右侧旁道５例 ，房室结双径路（ＡＶＮＤＮ）１６例，室速１例；对照组１２例均进行普通导管检查，男１０例，女２例 ，年龄２４～６２岁。两组患者分别在术前、术后即刻、术２４ｈ采血测定心肌酶ＣＫ—ＭＢ及肌钙蛋 白Ⅰ水平。结果：消融组术后ＣＫ—ＭＢ均有不同程度的升高，阳性率占３７．５％，ｃＴｎＩ阳性率占 ３０％，与对照组相比差异有显著性（Ｐ＜０．０５），ＣＫ—ＭＢ升高与消融时间、消 融次数呈正相关（ｒ＝０．８０２６３２，ｒ＝０．７３８６０８），（Ｐ＜０．０１）。与平均功率不相关 （ｒ＝－０．１３８０８），（Ｐ＞０．０５）。消融左侧旁道引起的心肌损伤明显，占７５％。结 论：射频消融术在治疗快速心律失常的同时，对心脏组织有不同程度的损伤，但较轻微，并 可迅速修复，其消融时间、放电次数、放电部位与ＲＦＣＡ所致的心肌损伤密切相关。
Objective:By measuring plasma level of the myocardial enzymes (CK-MB) and cardiac troponin I(cTnI)before,during and after radiofrequency catheter ablation(RFCA),the myocardium trauma and fact aff ecting factors made by RFCA was evaluated.Methods:RFCA group:thirty-two cases wi thout organic heart disease,including 24 males and 16 females,were enrolled in t he procedure.Among them,23 cases suffered from atrioventricular reentrant tachyc ardia (left side bypass tract 18,right side 5),16 cases atrioventricular junctio nal reentrant tachycardia.Common catheter group:12 cases.We took 3ml blood sampl e pre-,in,immediate,post-,and one day after the radiofrequency ablation procedur e and tested the plasma lever of myocardial enzymes and cTnI respectively.Result RFCA group:the plasma myocardial enzyme lever(CK-MB)increased 37.5% after the p rocedure.cTnI increased 30%.Linear correlation analysis showed that there were s ignificant correlation between the increasing magnitude of myocardial enzymes an d number of radiofrequency energy discharge(r=0.802632,P＜0.01)and the duration of the discharge(r=0.738608,P＜0.01).Conclosion:RFCA might m ake some injuries on myocardium when it acted as the treatment of tachyarrhythm ia.The major factor that can affect the size of lesion were number of target,tim es of the radiofrequency energy discharges and the position of the radiofrequenc y energy discharges.
出处
《内蒙古医学杂志》
2002年第2期116-118,共3页
Inner Mongolia Medical Journal
