射频消融对心肌的损伤作用及其对氧自由基和肿瘤坏死因子的影响

Effects of radiofrequency ablation on myocardial injury and its effects on oxygen free radicals and tumor necrosis factor

目的:探讨射频消融术对心肌、氧自由基及肿瘤坏死因子(TNF-α)水平的影响。方法:收治阵发性室上性心动过速(室上速)患者42例,分别在患者血管穿刺后(对照组)、心电生理检查后(术前)、射频消融后(术后)及术后3 d进行各项指标检查,观察射频消融对心肌、氧自由基以及TNF-α的影响。结果:心肌损伤情况对照组与术前对比差异无统计学意义(P>0.05);RFCA术后即刻,CK、CK-MB、GOT、LDH、HBDH以及Mb均有所升高,与术前对比差异有统计学意义(P<0.05)。而术后3 d所有指标均恢复术前水平,与术前对比差异无统计学意义(P>0.05)。氧自由基及TNF-α情况对照组与术前对比差异无统计学意义(P>0.05);RFCA术后即刻仅SOD水平与术前对比差异有统计学意义(P<0.05);而其余指标与术前对比差异无统计学意义(P>0.05)。且术后SOD恢复至术前水平对比差异无统计学意义(P>0.05)。结论:射频消融术虽然对心肌有损伤作用,也会造成微弱的氧自由基损伤,但术后一段时间内即可恢复,且对TNF-α水平无影响,较为安全。

Objective:To investigate the effects of radiofrequency ablation on myocardial,oxygen free radicals and tumor necrosis factor(TNF-alpha)levels.Methods:42 patients with paroxysmal supraventricular tachycardia were selected,the indexes were examined after vascular puncture(the control group),after electrophysiological examination(before operation),after radiofrequency ablation(after operation)and 3 days after operation,we observed the effects of radiofrequency ablation on myocardial,oxygen free radicals and TNF-alpha.Results:There was no significant difference in myocardial injury in the control group compared with before operation(P>0.05).Immediately after RFCA,CK,CK-MB,GOT,LDH,HBDH and Mb all increased,compared with before operation,the difference was statistically significant(P<0.05).On the 3 days after operation,all the indexes recovered to the preoperative level,compared with before operation,the difference was not statistically significant(P>0.05).In control group,compared with before operation,there was no significant difference in oxygen free radical and TNF-alpha(P>0.05).Immediately after RFCA,compared with before operation,the difference of SOD level was statistically significant(P<0.05),and there was no significant difference in other indexes(P>0.05).Postoperative SOD was returned to preoperative level,the difference was not statistically significant(P>0.05).Conclusion:Although radiofrequency ablation can damage the myocardium,it can also cause weak oxygen free radical damage,but they can be recovered within a certain period of time,and it had no effect on the level of TNFalpha,it was relatively safe.