【摘要】 目的探讨经静脉永久心脏起搏器植入前后不同时相血管内皮细胞和凝血分子标志物的变化及其临床意义。方法对48例缓慢型心律失常经静脉永久心脏起搏器植入患者(起搏器组)在植入起搏器前及植入后1d和7d、37例未经静脉永久心脏起搏器植入的缓慢型心律失常患者(无起搏器组)入院时及30例健康体检者(正常对照组),进行血浆血栓调节蛋白(TM)、血管性血友病因子(vWF)、凝血酶-抗凝血酶复合物(TAT)、组织因子(TF)含量检测,并进行比较分析。结果起搏器组和无起搏器组TM、vWF、TAT和TF均明显高于正常对照组(P<0.01),其中起搏器组变化更甚;起搏器植入后1d上述参数均明显升高(P<0.01);7d时TM和TAT仍处于明显升高状态(P<0.01)。结论缓慢型心律失常患者存在明显的血管内皮细胞损伤和凝血因子被活化,植入起搏器手术时会使这一状况加重。更多还原

【Abstract】 Objective To observe the changes of vascular endothelium and coagulant marker molecules before and after transvenous implantation of permanent pacemaker.Methods Blood samples were taken from 48 patients with bradyarrhythmias who underwent trasvenous implantation of permanent pacemaker,before and 1d and 7d after operation,37 patients with bradyarrhythmias and 30 healthy subjects.Plasma concentrations of thrombomodulin(TM),von Willebrand factor(vWF),thrombin-antithrombin complex(TAT)and tissue factor(TF)were measured.Results The plasma concentration of TM,vWF,TAT和TF in both the pacemaker group and non-pacemaker group were all higher than those in normal controls(P<0.01),and pacemaker group changed more markedly.All parameters increased dramatically on the first day of implantation(P<0.01).TM and TAT were kept high levels on the d7 after the operation(P<0.01).Conclusion There are severe impairment of vascular endothelial cells and the activation of coagulant factors in patients with bradyarrhythmias,which would be aggravated by operation of pacemaker implantation.更多还原