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快速心房起搏后急性期心房内与外周区域血液凝固性的比较。

Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing.

作者信息

Yamada Shusaku, Hirao Daiki, Miura Naoki, Iwanaga Tomoko, Kawaguchi Takae, Yoshimura Aritada, Oomori Takahiro, Nagasato Tomoka, Maruyama Ikuro, Fukushima Ryuji

机构信息

Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan.

Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Koorimoto, Kagoshima 890-0065, Japan.

出版信息

Exp Anim. 2019 May 8;68(2):137-146. doi: 10.1538/expanim.18-0100. Epub 2018 Oct 31.

Abstract

The changes in intra-atrial blood coagulability of acute phase after development of atrial fibrillation (AF) have not been elucidated in human. In the present study, blood coagulability were examined in the intra-atrial and peripheral regions during the acute phase after development of rapid atrial pacing (RAP) in experimentally created model dog similar to AF, using Total Thrombus-formation Analysis System (T-TAS) that is capable of comprehensively evaluating thrombogenicity in the bloodstream in the microvascular channel. According to the results, both the coagulating function-evaluating time to +10 kPa (T) and occlusion time (OT) of the AR chip (chip for thrombus analysis mixed with coagulation and platelet) were significantly shortened in the atrial blood as early as 30 min after pacing (T, 150.5 ± 40.5 s; OT, 212.4 ± 44.3 s) compared to the pre-pacing levels (T, 194.5 ± 47.5 s; OT, 259.9 ± 49.5 s) (P<0.05). The OT of PL chip (chip for platelet thrombus analysis) was significantly shortened 30 min after pacing (231.8 ± 57.6 s), compared to the pre-pacing level (289.5 ± 96.0 s) (P<0.05). Meanwhile, none of T and OT of AR and PL chips showed any significant changes in the peripheral blood. The study demonstrated increase of blood coagulability 30 min after development of RAP. While no significant changes were observed in the peripheral blood in the present study, the outcome suggested that the anti-thrombus treatments are better to be started early after AF even if coagulability of the peripheral blood shows no change.

摘要

心房颤动(AF)发生后急性期心房内血液凝固性的变化在人体中尚未阐明。在本研究中,使用能够全面评估微血管通道内血流中血栓形成性的全血栓形成分析系统(T-TAS),在实验创建的类似于AF的模型犬中,于快速心房起搏(RAP)后急性期,对心房内和外周区域的血液凝固性进行了检测。结果显示,起搏后30分钟,心房血液中AR芯片(用于血栓分析的芯片,混合了凝血和血小板)的凝血功能评估时间至+10 kPa(T)和闭塞时间(OT)均显著缩短(T,150.5±40.5秒;OT,212.4±44.3秒),与起搏前水平相比(T,194.5±47.5秒;OT,259.9±49.5秒)(P<0.05)。PL芯片(用于血小板血栓分析的芯片)的OT在起搏后30分钟显著缩短(231.8±57.6秒),与起搏前水平相比(289.5±96.0秒)(P<0.05)。同时,AR和PL芯片的T和OT在外周血中均未显示任何显著变化。该研究表明,RAP发生后30分钟血液凝固性增加。虽然本研究中外周血未观察到显著变化,但结果提示,即使外周血凝固性无变化,抗血栓治疗最好在AF发生后尽早开始。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/085c/6511516/71fc49f3ebd3/expanim-68-137-g001.jpg

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