抗血小板制剂对射频消融术前后vWF、血小板和凝血纤溶活性的影响

目的：探讨消融技术后血栓栓塞的机制和预防的方法,为临床提供血栓栓塞并发症的防治方法。方法：在我科行射频消融术的室上速患者158名,年龄15-61岁,其中右侧旁道12例,双径路62例,左侧旁道84例。随机分为五组,组Ⅰ（n=31）术前未服抗血小板制剂,术后立即服用阿斯匹林0.3g,1／日;组Ⅱ（n=32）术前3天始服用阿斯匹林0.3g,1／日;组Ⅲ（n=30）术前3天始服用氯吡格雷75mg1／日;组Ⅳ（n=32）术前3天服用阿斯匹林0．3g＋氯吡格雷75mg 1／日;组V（n=33）术前3天始服用阿斯匹林0.3g,1／日,术后皮下注射速避凝0．4ml 1／日。分别于入院后、电生理检查前即成功放置鞘管后、消融前即静推肝素前、消融后即刻、消融后24h采血。测定血浆血小板仪颗粒膜蛋白（GMP-140）水平、D-二聚体、血管性假血友病因子（vWF）。结果：①组IGMP-140水平自穿刺后即开始上升,射频消融术后24小时仍处于较高水平,血管穿刺后电生理检查前明显升高为30．41±5．67ng／ml（P〈0．05）,而射频消融术后升高为60．4±12．79ng／ml（P〈0．05）,但组Ⅱ、Ⅲ、Ⅳ、Ⅴ尤其是组IVGMP-140水平始终处于相对较低的水平（P〈0．05）。②组ID-二聚体水平自穿刺后即开始上升,射频消融术后24小时仍处于较高水平,血管穿刺后电生理检查前明显升高为0．58±0．22mg／L（P〈0．05）,而射频消融术后升高为1．50±0．56mg／L（P〈0．05）。组Ⅱ、Ⅲ、Ⅳ、Ⅴ尤其是组ⅣD-二聚体水平与组Ⅰ相比始终处于较低水平（P〈0．05）。③血浆vWF的水平：各组vWF水平自血管穿刺结束后即明显升高（P〈0．05）,射频消融术后组Ⅰ、Ⅲ升高明显,而组Ⅱ、Ⅳ、VvWF水平只有轻度升高（P〈0．05）,各组vWF水平在术后24小时仍维持相对较高的水平。④血浆GMP-140、D-二聚体、vWF在射频消融前后的改变与累及放电量、放电时间、放电次数、消融时间及肌钙蛋白Ⅰ等无关（P〈0．05）。结论：射频消融对内皮细胞有损伤作用,可导致GMP-140、D-二聚体的明显升高呈血栓前状态。不同的抗血小板制剂对其有改善作用。阿斯匹林可能降低血浆中vWF水平。     

The effect of tuftsin on fibrin polymerization in vitro and on the hemostatic system when administered intravenously to healthy animals

Taftsine tetrapeptide has antiprocoagulatory properties in vitro in the presence of plasma. Taftsine exerts depolymerization influence on fibrin monomer in concentrations of 10(-1) to 10(-9) mg/ml. At intravenous injection in doses of 1 mg and 300 ug/kg, taftsine causes the increase in plasma clotting time and significant increase in enzymatic and nonenzymatic fibrinolysis. The effect can be observed during 120 min after injection of the peptide.     

The action of timoptin peptides on the hemostatic system

Repeated introduction of thymus polypeptide drug thymoptine (8 times every 24 hours, 1 microgram/kg) led to the increase in total and non-enzymatic fibrinolytic activity of blood plasma and the decrease in fibrinogen concentration. Thymoptine could lyse non-stabilized fibrin and cause depolymerization of aggregates of fibrin monomer in virto. Highest depolymerization activity was observed at thymoptine concentration of 10 micrograms/ml.     

Effect of an activity entailing emotional strain on sensory and secretory processes in the oral cavity

The changes in taste sensitivity and lipid peroxidation in pooled samples of saliva of students taking examinations were studied. It was found that the changes in the parameters studied were related to the rate of their restoration and depended on the degree of emotional stress.     

Effect of heparin on the vascular thrombocytic link of the hemostatic system and pathogenetic correction of ensuing disorders

Intravenous injection of heparin (750 U/kg) induced thrombocytopenia, intravascular platelets aggregation and decreased prostacyclin-like vascular wall activity. Adverse side-effects may be prevented by injection of heparin in complex with nicotinic acid (1.5 mg/kg) and dipyridamole (2.5 mg/kg).