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目的:通过测定接受导管射频消融术(RFCA)的患者其血栓前状态敏感标志物CD62P、Ⅱb/Ⅲa、凝血酶原时间(PT)、血浆凝血因子Ⅰ(FIB)水平的改变,探讨RFCA与血栓前状态的关系及相应的干预措施,以便减少RFCA后血栓并发症的出现。方法:设健康对照组20例。接受RFCA治疗的67例房室结折返性心动过速患者(RFCA组)随机分为2亚组,其中肝素亚组为29例,非肝素亚组38例。2亚组共采静脉血5次:静脉鞘置入即刻①、心内电生理检查后②、射频消融完成即刻③、术后24h④、术后48h⑤;①、②、③、④、⑤时间点检测CD62P、Ⅱb/Ⅲa,在①、④时间点检测PT、血浆FIB水平。结果:实验组CD62P、Ⅱb/Ⅲa在RFCA后即刻与术前比较有显著性增高(P<0.05);术后24h接近术前水平(P>0.05),仍高于对照组(P<0.05),术后48h与对照组比较差异无统计学意义(P>0.05)。肝素亚组与非肝素亚组CD62P、Ⅱb/Ⅲa在术前、术后比较差异无统计学意义(P>0.05);PT、血浆FIB水平术后24h与术前比较差异无统计学意义(P>0.05)。结论:RFCA可引起血栓前状态,肝素亚组与非肝亚素组血小板活化表达差异无统计学意义。PT、FIB不如CD62P、Ⅱb/Ⅲa敏感。
Objective: To investigate the changes of the levels of CD62P, Ⅱb / Ⅲa, prothrombin time (PT) and plasma clotting factor Ⅰ (FIB) in patients with RFCA before and after radiofrequency catheter ablation (RFCA) The relationship between the status and the corresponding interventions in order to reduce the occurrence of thromboembolic complications after RFCA. Methods: A healthy control group of 20 cases. Sixty-seven patients with RFCA who underwent RFCA were randomized into 2 subgroups, including 29 in the heparin subgroup and 38 in the non-heparin subgroup. 2 subgroups received 5 times of venous blood: vein sheath immediately ①, after electrophysiological examination ②, radio frequency ablation completed immediately ③, 24h ④ postoperative 48h⑤; ①, ②, ③, ④, ⑤ point in time Detection of CD62P, Ⅱ b / Ⅲ a, ①, ④ time point detection of PT, plasma FIB levels. Results: The levels of CD62P and Ⅱb / Ⅲa in experimental group were significantly increased immediately after RFCA compared with that before operation (P <0.05); the levels of CD62P and Ⅱb / Ⅲa in experimental group were significantly higher than those in control group (P <0.05) , 48h after surgery compared with the control group no significant difference (P> 0.05). There was no significant difference in preoperative and postoperative levels of CD62P and Ⅱb / Ⅲa between heparin subgroup and non-heparin subgroup (P> 0.05). There was no significant difference in PT and plasma FIB levels between preoperative and postoperative 24h (P > 0.05). Conclusion: RFCA can cause prethrombotic state, heparin subgroup and non-heparin platelet activation expression difference was not statistically significant. PT, FIB as CD62P, Ⅱ b / Ⅲ a sensitive.