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Objective: Radiofrequency ablation (RFCA) of postoperative thromboembolic complications of the growing attention has been paid, the related thromboembolic complications formation of the mechanism has not been elucidated, the RF damage whether thrombosis borne, and over the years has been a contentious issue. Finished far few people do this System, more rare long-term follow-up of the system. D-dimer (DD) and platelet alpha granule membrane glycoprotein (GMP-140) is the most reflect specific thrombin activation and platelet activation flag hypercoagulability or prothrombotic state of molecular markers, on the RFCA The patients in the intraoperative and postoperative February detect blood in DD and GMP-140 concentration quantitative detection and analysis, we observed the change of the the postoperative the hemagglutination state of RFCA surgery, this article aims RFCA surgery surgery detection of clinical significance, after DD concentration and GMP-140 series, and at the same time to detect protein C, protein S, and to study the impact of RFCA on the coagulation status. Methods: consecutive since October 2006 to June 2007, 31 received RFCA treatment of tachyarrhythmia patients into the experimental group (male 13, female 18 cases --- to avoid the menstrual period, with an average age of 42 ± 16 years old from 17 to 71 years, the average number of discharges 5.3 ± 3.4 times), including the atrioventricular bypass in 12 cases (4 cases of the right side of the bypass, left eight cases), 15 cases of atrioventricular nodal reentrant tachycardia, atrial tachycardia two cases, the left and right ventricular tachycardia in 1 case. All patients had no thromboembolic and hemorrhagic disease history, their liver and kidney function, platelet count, coagulation phase were within the normal range, preoperative taking affect clotting drug history, postoperative of herein are aspirin 0.1qd to three months. Preoperative disable more than five half-lives of the antiarrhythmic drugs. Left heart catheterization preoperative vascular sheath injection heparin sodium 2000u, right heart catheterization is generally not injected with heparin sodium. Self-control methods for statistical analysis. Instantly after preoperative electrophysiological studies (EPS), RFCA immediately and postoperative 24h, 3d, 7d, January, February 7 periods venous blood. When blood within the sheath first extract the the 4ml abandoned, then take the 4ml. Measured by ELISA: GMP-140 with 2% diethylamine tetra-acetic acid (EDTA) anticoagulant tube, DD 109mmol / L sodium citrate tube were mixed at ratio of 9:1: immune rocket electrophoresis method for the determination : 10g / l agarose solution preparation of protein C (PC) buffer, protein S with 109mmol / l sodium citrate anticoagulant tubes, 3000 rpm centrifugation for 5 minutes the supernatant plasma, and stored at -86 ° C, do protein C, protein S, GMP-140, DD detection. Results 1. Average plasma DD concentration (ug / l) levels rose from baseline values ??(370 ± 75) to: after electrophysiological mapping (803 ? 138, P <0.001), discharge after its value was significantly increased from baseline values more than 3-fold (987 ± 125P <0.001), 24h after surgery and postoperative 3d DD is still higher than preoperative levels, postoperative 7d than puncture level slightly higher (410 ± 72, P> 0.05), after 1 month recovery before puncturing level (368 ± 79, p> 0.05). 2.GMP-140 concentration (ug / ml) a dynamic change: After electrophysiological mapping rise to the baseline value (11.98 ± 1.78) (15.90 ± 1.53, P <0.005), after discharge, the value increased to again 2 times the baseline value (21.60 ± 2.11 P <0.001), DD concentration, however, postoperative 24h ~~ 3d, GMP-140 continued to increased to (1480 ± 1 65, P <0.001) and the baseline value more than three times the level slightly higher postoperative 7d than puncture (15.20 ± 2.10, P> 0.05), after 1 month recovery before the puncture level (12.18 ± 1.89, P> 0.05). 3.GMP-140, DD RFCA procedures variable analysis: GMP-140, DD concentration and discharge time, X-ray exposure time, cumulative discharge energy and duration of surgery was no correlation (P> 0.05), gender factors no effect on the measured value of 1.4. intravenous heparin is no impact on platelet activation, however the heparin group, and 3d ~~ days after discharge after plasma DD concentration increased more significantly than the non-heparin group (respectively: P < 0.05, P <0.002). Protein C and protein S: detection of intraoperative and postoperative seen significant change (P> 0.05). Conclusion: RF ablation increased postoperative plasma DD concentration, sustained over 7d. 2.RFCA surgery can lead to DD elevated in the patient's blood, mostly transient, persistent increases are often prompted the occurrence of thrombotic diseases. 3.RFCA postoperative GMP-140 concentration increased, DD longer duration. The 4.EPS and RFCA surgery can cause platelet activation, fibrinolytic system activation, coagulation status changes, causing thrombosis. . Concentration of heparin after RFCA DD increased some inhibition RFCA-induced coagulation status change but not enough to produce a protective effect, the clinical need for further research to find better anticoagulant and anti-platelet activating drugs to reduce the potential thrombotic risk of RFCA. 6.EPS and RFCA surgery the protein C, protein S is no effect.
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