起搏模式对病态窦房结综合征患者中医证候及血流动力学的影响  

Influence of Different Cardiac Pacing Modes on TCM Syndrome Manifestations and Hemodynamics of Sick Sinus Syndrome

作　　者：曹爱琴[1] 杨广[1] 

机构地区：[1]广东省中医院心脏中心,广州市大德路111号510120

出　　处：《中医杂志》2008年第9期806-808,共3页Journal of Traditional Chinese Medicine

摘　　要：目的探讨起搏器不同起搏模式对病态窦房结综合征患者中医证候的影响及其血流动力学机制。方法75例病态窦房结综合征患者在起搏器植入术前及术后1个月进行证候症状积分及血流动力学指标检查,比较不同起搏模式间证候症状积分及血流动力学指标的差异性。结果起搏器植入术后中医证候症状积分均低于手术前(P<0.05)。AAI起搏及DDD起搏对左室射血分数(LVEF)、每搏射血量(SV)、心排血量(CO)、心排血指数(CI)、左室舒张末容积(LVEDV)的改善与VVI起搏比较差异有统计学意义(P<0.05),AAI起搏对CO、CI及LVEDV的改善与DDD起搏相比差异有统计学意义(P<0.05)。结论起搏器植入可改善病态窦房结综合征患者血流动力学及中医证候,而不同的起搏模式中,AAI起搏优于DDD起搏优于,VVI起搏,提示起搏治疗可通过血流动力学因素中CO、CI、LVEDV从而影响病态窦房结综合征的中医证候。Objective To evaluate the influence and mechanism of different cardiac pacing modes on TCM syndrome manifestations and hemodynamies of sick sinus syndrome （SSS）. Methods The 75 SSS patients were detected syndrome manifestation scores and hemodynamie parameters before operations and 1 month after pacing to compare the differences among the different cardiac pacing modes. Results After operations, the syndrome manifestation scores were all decreased （P 〈 0. 05）. Compared with VVI group, the improvement of hemodynamic parameters was statistically significant in AAI and DDD groups in left ventrieular ejection fraction （LVEF）, stroke volume （SV）, cardiac output （CO）, cardiac index （CI） and left ventricle end-diastolic volume （LVEDV, P〈0.05）. Compared with DDD group, the improvement of hemodynamic parameters was statistically signifieant in AAI group in CO, CI and LVEDV （P〈0.05）. Conclusion The TCM syndrome manifestations and hemodynamics of SSS patients can be improved by pacemaker. AAI pacing is better than DDD pacing and VVI pacing in exerting the influence on the TCM syndrome manifestations of SSS by improving CO, CI and LVEDV.

关 键 词：病窦综合征 中医证候 起搏模式 血流动力学 

分 类 号：R541.7[医药卫生—心血管疾病] R259[医药卫生—内科学]