【摘要】 目的　通过动态观察射频消融术患者血浆心肌酶的变化 ,评价射频消融术对心肌的损伤。　方法　 6 0例患者 ,男性 2 7例 ,女性 33例 ,年龄 6～ 6 7岁 ,均无器质性心脏病。其中 ,房室结交界区折返性心动过速 16例 ,房室旁路参与的房室折返性心动过速 37例 (左侧旁路 2 2例 ,右侧旁路 15例 ) ,房性心动过速 1例 ,特发性室性心动过速 2例 ,心房扑动 4例。分别在术前、术中、术后即刻及术后 1d采血 3 m l,测定血浆心肌酶的水平。　结果　射频消融术术后 ,血清心肌酶活性均有不同程度的升高 ,以乳酸脱氢酶、肌酸磷酸激酶同工酶的升高最明显 (P<0 .0 1) ,术后 1d均恢复到基础值。线性相关分析表明 ,心肌酶活性的升高程度与放电次数及消融时间呈高度正相关 (分别为 r=0 .85 5 7,P <0 .0 0 1;r=0 .6 86 8,P<0 .0 0 1)。　结论　射频消融术在治疗快速性心律失常的同时 ,对心肌组织有不同程度的损伤 ,其主要影响因素是放电次数的多少及消融时间的长短更多还原

【Abstract】 Objective By measuring plasma level of the myocardial enzymes before,during,and after radiofrequency catheter ablation(RFCA),the myocardium trauma made by RFCA was evaluated. Methods Sixty cases without organic heart diseases,including 27 males and 33 females,were enrolled in the procedure.Among them,16 cases suffered from atrioventricular junctional reentrant tachycardia,37 cases atrio ventricular reentrant tachycardia(left side bypass tract 22,right side 15),1 case atrial tachycardia.2 cases idiopathic ventricuar tachycardia,and 4 cases atrial flutter.We took 3 ml blood sample pre ,in,immediate post ,and one day after the radiofrequancy ablation procedure and tested the plasma level of myocardial enzymes respectively. Result The plasma myocardial enzyme level increased to some extent after the procedure,especially lactic dehydrogenase(LDH),creatine phosphokinase isoenzyme MB(CK MB, P <0 01).The plasma level of all kinds of enzymes declined to the basic level one day after the procedule.Linear correlation analysis showed that there were significant correlation between the increasing magnitude of myocardial enzymes and he number of radiofrequency energy discharge ( r =0 8557, P <0 001),or and the duration of the discharge( r =0 6868, P <0 001). Conclusion RFCA might make some injuries on myocardium when it acted as the treatment of tachyarrhythmias.The major factors that can affect the size of lesion were the number and the duration of the radiofrequency energy discharges.更多还原