植入型心律转复除颤器对缺血性心肌病患者病死率的影响  

Effect of implantable cardioverter defibrillator therapy on the mortality of patients with ischemic cardiomyopathy

作　　者：闫振娴[1] 周玉杰[1] 赵迎新[1] 李月平[1] 杨丽霞[1] 张琳琳[1] 梁静[1] 王志坚[1] 

机构地区：[1]首都医科大学附属北京安贞医院十二病房,北京100029

出　　处：《心肺血管病杂志》2008年第3期155-157,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:缺血性心肌病伴左心室功能不全[射血分数(EF)<40%]和恶性室性心律失常的患者预后不良,研究比较植入型心律转复除颤器(ICD)和传统药物治疗对这组患者病死率的影响。方法:回顾性分析2002年1月至2006年3月明确诊断为缺血性心肌病伴左心室功能不全(EF<40%)及恶性室性心律失常的患者152例,其中男性97例,女性55例,平均年龄(58.2±23.4)岁,其中ICD植入患者15例(A组),传统药物治疗患者137例(B组),随访(14±3)个月,主要终点事件为任何原因的死亡。结果:A组患者只有1例(6.7%)死亡,但对其ICD事件进行回顾性分析证实死亡为非恶性室性心律失常所致。B组患者死亡19例(13.9%),其中6例患者死于恶性室性心律失常。2组患者的病死率差异无显著性(P>0.05)。但对ICD植入患者的程控发现ICD共成功纠正心室颤动(VF)发作21次,持续性室速(VT)发作65次。结论:本研究提示ICD可降低缺血性心肌病患者恶性室性心律失常导致的猝死。Objective：Patients with ischemic cardiomyopathy （EF 〈 40% ） and ventricular tachyarrhythmias have a poor outcome. We compared the effect of ICD with traditional drug therapy on the mortality rate of these patients. Method：Between January. 2002 and March 2006, 152 patients [97 males, 55 females, （58.2 ± 23.4） yrs] with ischemic cardiomyopathy （EF 〈 40 % ） and history of ventricular tachyarrhythmias were treated at our institution. Patients who had ICD implantation （group A, 15 cases） were compared with those only received traditional medicine （group B, 137 cases）. All the patients were followed up for 14 ± 3 months. The primary endpoint is all-cause death. Result： During the follow up, one patient （6.7 % ） of group A died, but not of ventricular tachyarrhythmia. Of group B patients, 19 （ 13.9 % ） died and 6 were sudden death. The difference of mortality rate between the two groups is not significant （ P = NS）. However, successful terminations of 21 ventricular fibrillations and 65 sustained ventricular tachycardias were found in group A. Conclusion： In the study, ICD appears to reduce the incidence of sudden cardiac death by termination of ventricular tachyarrhythmia for patients with ischemic cardiomyopathy.

关 键 词：心肌病 缺血性 心律转复除颤器 植入型 室性心律失常 病死率 

分 类 号：R541.7[医药卫生—心血管疾病]