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目的:探讨射频导管消融术对血小板活性的影响及术前应用阿司匹林的干预作用。方法:选择行射频导管消融术患者168例,将其随机分为两组:阿司匹林组(n=88):术前3天口服阿司匹林;对照组(n=80):术前不用任何药物。分别于术前(T0)、电生理检查后(T1)、放电消融成功后30分钟(T2)、术后2天(T3)测定血浆中血小板α-颗粒膜糖蛋白和血栓烷素B2的含量,并比较两组内不同时间点各指标的变化和两组间各指标的差异。结果:对照组血浆血小板α-颗粒膜糖蛋白和血栓烷素B2含量在T1时刻较T0时刻有明显升高(均P<0.01),T2时刻进一步升高达到峰值(均P<0.001),T3时刻虽有所下降,但仍明显高于T0时刻(P<0.01);阿司匹林组血浆血小板α-颗粒膜糖蛋白和血栓烷素B2在T1、T2、T3时刻与T0时刻比较无明显升高(P>0.05),但与对照组T1、T2、T3同时间点比较升高的幅度明显降低(P<0.01~0.001)。结论:射频导管消融术可引起血小板激活,可能致血栓形成,术前服用阿司匹林可阻止血小板激活,有防止血栓形成的效果。
Objective: To investigate the effect of radiofrequency catheter ablation on platelet activity and the effect of aspirin preoperatively. Methods: A total of 168 patients underwent radiofrequency catheter ablation were randomly divided into two groups: aspirin group (n = 88): aspirin 3 days before operation; control group (n = 80): no drug was used before operation. Plasma levels of platelet α-granule membrane glycoprotein and thromboxane B2 were measured before operation (T0), after electrophysiological examination (T1), 30 minutes after successful discharge ablation (T2) and 2 days after operation . The changes of each index at different time points in two groups and the differences of each index between the two groups were also compared. Results: The contents of plasma platelet α-granule membrane glycoprotein and thromboxane B2 in control group were significantly higher than those at T0 (all P <0.01) at T1 and further peaked at T2 (all P <0.001) Although the time had declined, it was still significantly higher than that at T0 (P <0.01). The plasma platelet α-granule membrane glycoprotein and thromboxane B2 in aspirin group had no significant increase at T1, T2, T3 and T0 P> 0.05). However, the amplitude at the same time point of T1, T2 and T3 decreased significantly (P <0.01 ~ 0.001). Conclusion: Radiofrequency catheter ablation can cause platelet activation, may lead to thrombosis, preoperative aspirin can prevent platelet activation, to prevent the effect of thrombosis.