右室室间隔起搏与心尖部起搏对心功能影响的比较  

Comparison of cardiac function between right ventricular septal pacing and right ventricular apex pacing

作　　者：韦彩雯[1] 毛家亮[1] 何奔[1] 郝静[1] 

机构地区：[1]上海交通大学医学院附属仁济医院心内科,上海200025

出　　处：《心脏杂志》2009年第4期528-530,共3页Chinese Heart Journal

摘　　要：目的比较右室室间隔起搏与心尖部起搏对患者心功能的影响。方法180例患者随机分为右室室间隔部起搏组(n=98例)和右室心尖起搏组(n=82例)。比较两组患者术前与术后第18个月心脏彩超的变化。结果间隔组患者的左室射血分数(LVEF)较术前显著提高[(66±8)%vs(69±9)%,P<0.01],心搏出量(SV)较术前显著提高[(83±15)mlvs(87±12)ml,P<0.01],左室舒张末期内径(LVEDD)缩小未达显著水平[(52±5)mmvs(51±5)mm],左室收缩末期内径(LVESD)无明显变化[(31±5)mmvs(31±5)mm],而心尖组LVEF显著降低[(68±7)%vs(63±8)%,P<0.01],SV显著减少了7ml[(87±16)mlvs(80±10)ml,P<0.01],LVEDD显著增大3mm[(50±6)mmvs(53±7)mm,P<0.01],LVESD显著增大[(30±5)mmvs(32±6)mm,P<0.05],两组患者各观察指标同期比较术前无统计学意义,术后18个月LVEF差异有非常显著统计学意义(P<0.01),SV差异有统计学意义(P<0.05)。结论右室室间隔起搏较右室心尖部起搏更利于起搏器植入患者的心功能保护。AIM： To compare the cardiac function between right ventricular septal pacing and right ventricular apex pacing. METHODS： A total of 180 cases were randomly divided into ventricular septal pacing group （n = 98 cases） and apex pacing group （n = 82）. Changes in the echocardiogram of the two groups were compared before surgery and 1.5 years after surgery. RESULTS： Left ventricular ejection fraction （LVEF） in septal group increased [ （66 ± 8）% vs. （69 ±9）%, P 〈 0.01 ], stroke volume （SV） increased [ （83±1 ） ml vs. （87 ± 12） m], P 〈 0.01 ], left ventricular end-diastolic diameter （LVEDD） decreased [ （52±5） mm vs. （51 ±5） mini, and no significant change was found in left ventricular end-systolic diameter （LVESD） [ （31± 5 ） mm vs. （31 ±5） mm ]. In apex group, LVEF significantly decreased [（68 ±7）% vs. （63 ±8）%, P 〈0.01], SV significantly decreased [ （87 ±16） ml vs. （80 ± 10） ml, P 〈0.01 ], and a significant increase was found in LVEDD [ （50±6） mm vs. （53 ±7） mm, P 〈0.01 ] and in LVESD [ （30 ±5） mm vs. （32 ±6） mm, P 〈0.05]. Eighteen months after operation, LVEF （P 〈0. 01 ） and SV （P 〈0. 05 ） were significantly different between groups. Pre- and postoperative difference between groups was statistically significant （P 〈 0. 05）. CONCLUSION： Ventricular septal pacing is superior to right ventricular apex pacing in improving cardiac function in patients with pacemaker implant.

关 键 词：右室流出道 室间隔 右室心尖部 起搏 

分 类 号：R541.7[医药卫生—心血管疾病]