心脏再同步治疗慢性心力衰竭随访疗效分析  

Long term therapeutic effect of cardiac resynchronization therapy on patients with congestive heart failure

作　　者：袁沃亮[1] 孔敏仪[1] 王景峰[1] 林永青[1] 聂如琼[1] 谢双伦[1] 

机构地区：[1]广州中山大学附属第二医院心内科,广东广州510120

出　　处：《中国心脏起搏与心电生理杂志》2009年第4期306-308,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：2007-2009卫生部临床学科重点项目;2007年度广东省自然科学基金重点项目(批准号7117378);2006年广东省自然科学基金(批准号6021378);2006年度省卫生厅基金(批准号A2006201);2007年度广东省科技计划项目(项目编号:0711220600313);广州市科技攻关计划项目(项目编号:2007Z3-E0091)

摘　　要：目的探讨心脏再同步化治疗(CRT)对慢性充血性心力衰竭近远期治疗的效果。方法心力衰竭患者48例,男31例、女17例,年龄62.0±15.6(35～80)岁,其中扩张型心肌病28例,高血压性心脏病2例,缺血性心肌病l3例,Ⅲ度房室传导阻滞5例。心功能Ⅲ级(NYHA分级)34例、Ⅳ级14例。植入CRT系统(含CRTD),随访23.4±15.8个月。结果48例中有良好反应者32例,对治疗无明显反应者11例。死亡9例,其中2例猝死,4例死于心力衰竭恶化。结论CRT疗效肯定,定期随访和程控,将有助于减少无反应者。CRTD有助于降低猝死的发生。Objective To analyze the long term therapeutic effect of cardiac resynchronization therapy （CRT） on patients with congestive heart failure（CHF）. Methods Forty -eight patients with CHF were enrolled, including 31 male and 17 female with mean age 62.0 ± 15.6 years. The etiologies of heart disease were dilated cardiomyopathy （ n = 34 ） , hypertension cardiomyopathy （ n = 2 ） , third degree atrioventricular block （ n = 5 ） and ischemic myocardiopathy （ n = 13 ） , with New York Heart Association （NYHA） class Ⅲ（n = 34） and class Ⅳ （n = 14）. The patients received CRT（D） implantation, with mean follow-up period 23.4 ± 15.8 months. Results Thirty-two patients were responders for CRT, while 11 were non-responders. 9 patients died during follow-up, 2 of those died from sudden death, 4 of those died from worsening heart function. Conclusions Improvement of clinical symptoms has been proved after CRT, and regular follow-up and programming CRT may reduce non-responders for CRT. CRTD can reduce the prevalence of sudden death.

关 键 词：心血管病学 心脏再同步治疗 心力衰竭 死亡 

分 类 号：R318.11[医药卫生—生物医学工程] R541.61[医药卫生—基础医学]