生理性与非生理性起搏对血浆脑利钠肽及心功能的影响  

Effect of brain natriuretic peptide and cardiac function in physiologic and non-physiologic pacing

作　　者：李春兰 蒲志宏 郭从芳 马晓庆 袁若雯 侯鹏 李丽[2] 

机构地区：[1]甘肃省干部医疗保健院心内科,兰州市730020 [2]甘肃省人民医院心内科,730020

出　　处：《中国心血管病研究》2008年第3期196-197,共2页Chinese Journal of Cardiovascular Research

摘　　要：目的研究生理与非生理性起搏方式对血浆脑利钠肽水平及左室射血分数的影响。方法74例置入了永久性心脏起搏器心功能I-II级(纽约心脏协会分级)的患者,分为生理性起搏组(48例)与非生理性起搏组(26例),术前测血浆脑利钠肽,心脏彩色多普勒超声测定左室射血分数,术后随访3年,测定血浆脑利钠肽和左室射血分数。对两组术前、术后血浆脑利钠肽及左室射血分数状况进行自身和组间对比分析。结果生理性起搏组术后血浆脑利钠肽较术前有所增高,分别是(48.21±17.55)pg/ml和(55.07±17.62)pg/ml,但差异无统计学意义(t=1.632,P=0.10),而左室射血分数无变化;非生理性起搏组术后血浆脑利钠肽较术前明显增加,分别是(88.86±18.74)pg/ml和(46.92±19.15)pg/ml(t=7.981,P<0.01),而左室射血分数较术前下降,分别是(59.85±5.69)%和(54.25±3.12)%(t=3.473,P=0.002);术后生理性起搏组血浆脑利钠肽水平较非生理性起搏组低,分别是(55.07±17.62)pg/ml和(88.86±18.74)pg/ml(t=7.568,P<0.01),左室射血分数较非生理性起搏组高,分别是(54.25±3.12)%和(61.13±4.01)%(t=8.394,P<0.01)。结论生理性起搏与非生理性起搏方式相比血浆脑利钠肽水平较低,对心脏功能影响较小,起搏器综合征发生较少。Objective To study and evaluate the effect of physiologic（DDD） and non-physiologic （VVI） pacing on the B-type natriuretic peptide （BNP） level in plasma and left ventricular ejection fraction （LVEF）. Methods Seventy four pacemaker implanted patients of New York Heart Association （NYHA） class I to II were divided into DDD （n=48） group and VVI （n=26）group.BNP and LVEF were measured and analyzed before and 3 years after the operation. Results After the operation,the BNP increased slightly [from （48.21±17.55）pg/ml to （55.07±17.62）pg/ml] （t=1.632,P=0.10）and LVEF has no changes in DDD group, and the BNP increased[from （46.92±19.15）pg/ml to （88.86±18.74）pg/ml] （t=7.981,P〈0.01）,LVEF decreased [from （59.85 ±5.69）% to （54.25±3.12）%（t=3.473,P=0.002） significantly in VVI group. The BNP was lower[from （88.86±18.74）pg/ml to （55.07±17.62）pg/ml）（t=7.568,P〈0.01） and the LVEF was higher[from （54.25±3.12）% to（61.13±4.01 ）%] （t= 8.394,P〈0.01） in DDD group than that in VVI group. Conclusion DDD pacing has slight effect on the BNP level and LVEF compared with that of VVI pacing and may be of less possibility to worsen the heart function and the pacemaker syndrome in patients.

关 键 词：利钠肽 脑 射血分数 左室 心脏起搏 人工 

分 类 号：R541.7[医药卫生—心血管疾病]