射频导管消融术后部分凝血与纤溶指标的变化

目的观察射频导管消融术(RFCA)对患者术后部分凝血与纤溶指标变化的影响,以及术后恢复时间。方法对56例接受RFCA治疗的患者,在RFCA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(DD)、血管内血友病因子(vWF)、血浆组织纤溶酶原(t-PA)和组织纤溶酶原抑制物(PAI-1)含量。结果与术前比较,血浆DD、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(P0.01),并于第7天降至术前水平(P0.05),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(P0.01),并于第7天降至术前水平(P0.05)。结论 RFCA可引起血液中部分凝血与纤溶物质水平显著增加,术前、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。

The changes of blood coagulation and fibrinolytic indices after radiofrequency catheter ablation

Objective To observe the changes of blood coagulation and fibrinolytic indices after radiofrequency catheter ablation（RFCA）and the restoring time after RFCA.Methods The levels of D-dimer （DD）,von willebrand factor （vWF）,tissue plasminogen activator （t-PA）and plasminogen activator inhibitor （PAI-1 ）were determined in 56 patients undergoing RFCA after intracardiac electrophysiological study before RFCA,just at the time after RFCA and in 2 d and 7 d after RFCA.Results The levels of DD,vWF and PAI-1 increased significantly after intracardiac electrophysiological study before RFCA,just at the time after RFCA and in 2 d after RFCA （P〈0.01 ）,and restored in 7 d after RFCA （P〉0.05）.The t-PA decreased significantly after intracardiac electrophysiological study before RFCA, just at the time after RFCA and in 2 d after RFCA （P 〈0.01 ）,and restored in 7 d after RFCA （P 〉0.05 ）. Conclusions RFCA may increase the levels of blood coagulation and fibrinolytic indices.Monitoring the levels of D-dimer,vWF,t-PA and PAI-1 is valuable in guiding the administration of anticoagulative drugs and the prophylaxis of thromboembolic events.