心房顿抑犬D-二聚体及GMP_(140)浓度变化的研究

目的建立犬心房顿抑模型,观察相应凝血指标的改变及可能机制。方法12只犬麻醉后经静脉将导管插入右心耳,进行持续快速起搏300min(450次／min),其间持续血液动力学监护。应用二维及多普勒超声心动图观察是否存在自发性回声显像现象并评价左、右心房大小及功能。所有指标均在窦性心律下测量。用放射免疫法测定外周血血小板α颗粒膜蛋白(GMP140)和D-二聚体浓度。结果快速起搏5h后双房内径明显扩大,LAEF、RAEF及二尖瓣瓣尖水平舒张晚期A波流速峰值明显下降,证实心房顿抑发生。起搏后GMP140和D-二聚体浓度升高。结论心房顿抑时血栓前状态形成可能与血流瘀滞、血小板话化和高凝状态有关。

The changes of plasma D-dimer and GMP140 in canine with atrial stunning

Objective To investigate whether atrial stunning can cause prothrombosis state and to explore its possible mechanism.Method 12 dogs underwent a transvenous catheterization at the right atrial appendage that was continuously paced at 450 beats per minute for 5 hours.Two-dimention echocardiography and color Dopple was performed to observe the presence or absence of SEC and to assess the effects of rapid atrial pacing on atial size and function.All data points were acquired in sinus rhythm.Radioimmunoassay (RIA)was used to measure levels of plasmaα-Grannule membranal protein (GMP140) ,D -dimer.Result Marked biatrial enlargement was documented while LAEF,RAEF and the peak velocity of left atrial contraction were decreased significantly after 5 hours of continuous rapid atrial pacing,which showed atrial stunning occurred.Dogs after pacing had higher levels of GMP140 and D-dimer than those before pacing.Conclusion Prothrombosis state after cardioversion could be greatly associated with transient atrial dysfunction (atrial blood slasis),platelet activition and higher hemagglutinating state.