【摘要】 目的　通过观察超声与射频环状消融入心静脉口对血凝状态的影响 ,评价超声消融入心静脉口的安全性 ,为超声消融肺静脉口治疗局灶性心房颤动提供实验依据。方法　选用健康成年杂种犬 11只 ,随机分成两组 :5只行上、下腔静脉口超声消融 ,6只行上、下腔静脉口射频环状消融。分别在插管前、插管后、消融后即刻、消融后 30min及 4 8h取外周静脉血 5ml,用流式细胞仪动态检测血小板α 颗粒糖蛋白 (GMP 14 0 )阳性表达活化血小板百分率的变化 ,用发光底物法测定组织型纤溶酶原激活剂 (t PA)及组织型纤溶酶原激活剂抑制物 1(PAI 1)的变化。结果　超声消融组与射频消融组GMP 14 0阳性表达活化血小板百分率 ,在插管后较插管前明显升高 ,消融后即刻明显升高 ,且继续升高至消融后 4 8h。两组比较 ,消融后即刻、30min及 4 8h ,射频消融组GMP 14 0阳性表达活化血小板百分率均高于超声消融组。两组t PA及PAI 1在插管后较插管前无明显变化 ,t PA于消融后即刻达高峰 ,至消融后 30min开始下降 ,PAI 1于消融后 30min达高峰 ,两者均于消融后 4 8h恢复正常 ,两组t PA与PAI 1差异无显著性。结论　超声消融与射频消融均可激活血小板 ,使血液处于高凝状态 ,但超声消融对血小板激活程度低于射频消融 ,说明与射频消融相比 ,超声消?更多还原

【Abstract】 Objective To observe and compare the influences of radiofrequency catheter ablation (RFCA) and through-the-balloon ultrasound ablation (TTB-USA) on coagulable states of blood and evaluate their safety. Methods Eleven mongrel canines of either sex were divided into TTB-USA group (n=5) and RFCA group (n=6). We measured the expression of alphagranule membrane protein (GMP-140) on the surface of activated platelets by flow cytomety before and after cannulation, immediately after ablation, 30 minutes and 48 hours later, respectively. And at the same time,we also examined the change of tissue type plasminogen activatior (T-PA)? plasmingen activator inhibitor-1 (PAI-1). Results The expression of GMP-140 elevated before ablation, reached its peak value at hour 48, but the degree of uprising was lower in TTB-USA group than in RFCA group. Both t-PA and PAI-1 uprising just after ablation, restored to normal 48 hours later, t-PA reached its peak just after ablation, but PAI-1 was 30 minutes later and there was no difference in uprising degree between the two groups. Conclusion Both TTB-USA and RFCA could activate platelets and result in the change of blood coagulable states, but TTB-USA was slighter than RFCA, so TTB-USA seems to be more safely in ablating pulmonary vein orifice than RFCA in treatment of focal atrial fibrillation.更多还原