中国患者经导管房间隔缺损封堵术后凝血酶原形成和血小板活化增强。

Enhanced prothrombin formation and platelet activation in Chinese patients after transcatheter closure of atrial septal defect.

机构信息

Department of Cardiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, People's Republic of China.

出版信息

Clin Cardiol. 2010 Jul;33(7):E6-9. doi: 10.1002/clc.20752.

DOI:10.1002/clc.20752

PMID:20552683

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6653727/

Abstract

BACKGROUND

The objective of this study was to investigate changes in coagulation activation and platelet activation after transcatheter closure of atrial septal defect (ASD) by determining the levels of specific markers over time to provide insight into preventing postprocedural embolism.

HYPOTHESIS

We hypothesis that the activation status of coagulation and the platelet would be changed after the closure of ASD.

METHODS

Forty consecutive patients who underwent transcatheter closure of ASD with the Lifetech ASD occluder (Lifetech Scientific, Shenzhen, China) were included in this prospective study. The serum level of prothrombin fragment 1 + 2 (F1 + 2) and expressions of P-selectin (CD62P) and platelet glycoprotein IIb/IIIa receptor (CD41a) on the surface of platelets were evaluated at baseline and at 1 day, 1 month, and 3 months after the closure.

RESULTS

The median F1 + 2 level was 0.96 nmol/L. This increased to a maximal value of 1.43 nmol/L at 1 day after closure, but gradually returned to the baseline level at 1 month after closure and remained there at 3 months after closure (medians were 0.98 nmol/L and 1.08 nmol/L, respectively). Platelet surface expression of CD62P and CD41a decreased at 1 day, 1 month, and 3 months after closure. For CD62P, average expressions were 8.21% +/- 2.11%, 6.28% +/- 1.72%, 5.29% +/- 1.52%, and 4.41% +/- 1.11%, respectively, for baseline and 1 day, 1 month, and 3 months after closure. For CD41a, average expressions were 79.37% +/- 14.14%, 71.98% +/- 13.77, 56.69% +/- 13.05%, and 54.88% +/- 11.62%, respectively.

CONCLUSIONS

Transcatheter closure of ASD with the Lifetech ASD occluder was associated with significantly increased coagulation activation and decreased platelet activation. No evidence supporting the use of aspirin to prevent thrombus formation after closure was found.

摘要

背景

本研究旨在通过随时间测定特定标志物的水平，探讨经导管房间隔缺损（ASD）封堵术后凝血激活和血小板激活的变化，为预防术后栓塞提供依据。

假说

我们假设 ASD 封堵术后凝血和血小板的激活状态会发生变化。

方法

本前瞻性研究纳入了 40 例连续接受 Lifetech ASD 封堵器（Lifetech Scientific，深圳，中国）治疗的 ASD 患者。在基线时以及封堵后 1 天、1 个月和 3 个月时，评估了凝血酶原片段 1+2（F1+2）的血清水平以及血小板表面 P-选择素（CD62P）和血小板糖蛋白 IIb/IIIa 受体（CD41a）的表达。

结果

F1+2 水平的中位数为 0.96 nmol/L，在封堵后 1 天达到 1.43 nmol/L 的最大值，然后逐渐恢复至封堵后 1 个月的基线水平，并在封堵后 3 个月保持在该水平（中位数分别为 0.98 nmol/L 和 1.08 nmol/L）。CD62P 和 CD41a 的血小板表面表达在封堵后 1 天、1 个月和 3 个月时均下降。对于 CD62P，平均表达分别为基线时的 8.21%+/-2.11%、封堵后 1 天的 6.28%+/-1.72%、1 个月的 5.29%+/-1.52%和 3 个月的 4.41%+/-1.11%。对于 CD41a，平均表达分别为基线时的 79.37%+/-14.14%、封堵后 1 天的 71.98%+/-13.77%、1 个月的 56.69%+/-13.05%和 3 个月的 54.88%+/-11.62%。