射频导管消融术对凝血激活程度的影响

目的观察射频导管消融术（RFCA）对患者血中凝血激活程度的影响,以及术后恢复时间。方法对56例接受RFCA术的患者,在RFCA术前,心内电生理检查后,成功消融后即刻、术后第2天和第7天,抽取静脉血,测定D-二聚体（D-Dimer）、血管内血友病因子（Vonwillebrandfactor,vWF）,血浆组织纤溶酶原（Tissue Plasminogen Activator,t-pa）和组织纤溶酶原抑制剂（Plas-minogen Activator Inhibitor,PAI-1）含量。结果与术前比较,血清D-二聚体、vWF浓度以及血浆PAI-1含量在心内电生理检查后、消融成功后即刻和术后第2天均显著上升（P〈0.01）,并于第7天降至术前水平,而t-PA含量在心内电生理检查后,消融成功后即刻和术后第2天显著下降（P〈0.01）,并于第7天降至术前水平。结论 RFCA术可引起血中凝血物质水平的显著增加。术后、术后对其监测有利于指导抗凝药物应用和预防血栓栓塞的发生。

Effect of radiofrequency catheter ablation on changes of blood congealable states

Objective To observe the changes of the blood coaguable states affected by radiofrequency catheter ablation（RFCA）and the restoring time of the levels of the blood coaguable substance after RFCA.Methods The plasma levels of D-Dimer,vonwillebrandfactor（vWF）were assayed in 56 patients undergoing RFCA by ELISA.Blood samples were obtained by inserting veins before RFCA was performed,after electrophysiologic（EP）study was finished,just at the time that RFCA was accomplished,the second day and the seventh day after RFCA.Results The blood levels of D-Dimer,vWF and PAI-1 increased distinctly when electrophysiologic study was finished,just when RFCA was performed,and the second day after RFCA（P0.01）,and restored in the seventh day after RFCA（P0.05）.The blood levels of t-PA decreased distinctly when electrophysiologic（EP）study was finished,just when RFCA was performed,and the second day after RFCA（P0.01）,and restored in the seventh day after RFCA（P0.05）.Conclusions RFCA may change the blood coaguable states by increasing the levels of the blood coaguable substance.Monitoring the blood levels of D-Dimer,vWF,PAI-1 and t-PA is valuable in guiding the administration of anticoagulative drugs and prophylaxis of thromboembolic events.