不同起搏方式对起搏器置入患者血浆B型脑钠肽及心脏功能、结构的影响  

Influence of different pacing modes to plasma levels of brain natriuretic peptide and heart functions of patients with DDD pacemaker

作　　者：潘展群[1] 吴清华[1] 

机构地区：[1]南昌大学第二附属医院,江西南昌330006

出　　处：《山东医药》2009年第9期9-11,共3页Shandong Medical Journal

摘　　要：目的观察不起起搏方式对起搏器置入患者血浆B型脑钠肽及心脏功能、结构的影响。方法选择125例行起搏器置入患者,均置入DDD型起搏器,按心室导线固定部位不同分为右室心尖部起搏组和右室间隔部起搏组,比较两组手术前后心电图QRS间期、血浆B型脑钠肽(BNP)、超声心动图的变化情况。结果术前两组Ⅱ导联QRS间期、BNP、超声心动图检查结果无统计学差异,术后3个月时右室心尖部起搏组左房内径、左室舒张末期内径、室间隔厚度均较右室间隔部起搏组显著增大(P<0.05),射血分数显著下降(P<0.05),BNP显著升高(P<0.05)。结论右室心尖部起搏组与右室间隔部起搏相比,心腔扩大,射血分数下降,BNP水平增高明显。Objective To study the influence of different paceing modes to plasma levels of brain natriuretic peptide （BNP） and heart functions. Methods 125 patients were performed with DDD pacemaker, according to the site where the ventrieular pacing lead fixed. The patients were divided into right ventrieular apex（RVA） pacing group and right ventricular septum（RVS） pacing group, each group received ECG,echocardiography measurements and plasma levels of brain natriuretic peptide were assayed before and 3 months after the operation, then compared the difference between the two groups of each index. Results Before operation , each index of the two groups has no difference（P 〉 0.05） . 3 months later, the duration of QRS wave of lead Ⅱ of the RVA group were significantly prolonged than that of the RVS group（P 〈0.05）. The RVA group got left atrial diameter （LAD） ,left ventricular end diastolic diameter （LVEDD） ,intraventricular septum thickness（IVST） enlarged（ P 〈 0.05 ）, and left ventricular ejection fraction（LVEF） decreased obviously. The BNP levels of RVA group were extremely higher compared to that of before the operation. The parameters of RVS pacing group have no difference before and after operation. Conclusions Compared with RVS pacing group, the levels of plasma BNP of RVA group rise significantly higher, and the heart ftmetious decrease.

关 键 词：心脏起搏 人工 B型脑钠肽 电描记术 超声心动描记术 彩色多普勒 

分 类 号：R541.7[医药卫生—心血管疾病]