病窦综合征转为持续性心房颤动对运动耐量和生活质量的影响  

Effect of chronic atrial fibrillation on exercise tolerance and quality of life in paced patients with sick sinus syndrome

作　　者：王兵 黄德嘉 陈小鸥 唐炯 

出　　处：《中华心血管病杂志》1998年第5期352-355,共4页Chinese Journal of Cardiology

摘　　要：目的探讨心房颤动（房颤）病人在较好控制心室率后，房颤本身对运动耐量和生活质量有何影响。方法选择无其它器质性心脏病证据的病态窦房结综合征患者，在安置ＶＶＩ型心脏起搏器后，以无房颤的１５例为对照，比较其与发生慢性房颤后较好控制心室率的１５例患者在运动耐量和生活质量方面有无差异。结果房颤组的基础心率、第一级运动后心率和最大心率均显著高于对照组（８２．７５±１６．７２和６３．０７±６．４２次／分，Ｐ＜０．０１；１１４．０８±１２．０３和８２．６７±１２．０３次／分，Ｐ＜０．０１；１５２．１７±４２．３２和９６．２５±１８．４９次／分，Ｐ＜０．０１）。两组的运动持续时间和代谢当量相近（１５．１０±２．９２和１５．７８±２．５３ｍｉｎ，Ｐ＞０．０５；８．０８±１．７３和８．２５±１．２２ＭＥＴ，Ｐ＞０．０５）。房颤组和对照组的生活质量各维度评分相比，差异无显著性。躯体功能维度为３６．５８±２．８４和３６．８３±２．８６，Ｐ＞０．０５；因躯体功能所致角色限制为８．０８±２．３８和７．１７±１．５３，Ｐ＞０．０５；因情感问题所致角色限制为７．１７±１．０８和７．６±１．６１，Ｐ＞０．０５；社会功能为１７．６７±２．５３和１?Objective It is still unknown if heart rate is controlled well how chronic atrial fibrillation (CAF) itself influences exercise tolerance and quality of life. Methods After VVI pacemaker implanted, 15 with CAF isolated sick sinus syndrome (SSS) patients and 15 sex, age and heart functional class matched without CAF isolated SSS patients were selected.Rest heart rate of CAF patients was below 90 beats/minute (bpm) after digoxin (0.125mg once daily), or digoxin (0.125mg once daily) and metoprolol (12.5mg twice daily), or digoxin (0.125mg once daily) and diltiazem (30mg three times daily) administrated. All these patients took treadmill exercise testing and finished modified SF 50 questionnaire. Results The levels of rest heart rate after first stage and maximal heart rate of CAF group were significantly higher than control group (82.75±16.72 vs 63.17± 6.24 bpm. P <0.01; 114.08±30.42 vs 82.67±12.03 bpm. P <0.01; 152.17±42.32 vs 96.75±18.49bpm, P <0.01). There were no significant differences between CAF group and control group in exercise time (15.10± 2.92 vs 15.78±2.53 minute, P >0.05) and MET (8.08±1.73 vs 8.25±1.22 P >0.05). Scores of each dimention of modified SF 50 in CAF group were similar to control group (physical functioning 36.58± 2.84 vs 36.83 ±2.86, P >0.05; role physical 8.08±1.38 vs 8.17±1.53, P >0.05; role emotional 7.17±2.08 vs 7.67 ±1.61, P >0.05; social functioning 17.67±2.53 vs 18.17±2.89, P >0.05; general well being perceptions 52.75±6.03 vs 52.83±9.58, P >0.05;symptoms 15.08±1.73 vs 15.58±2.39, P >0.05). Conclusion There were no significant differences between CAF group and control group in exercise tolerance and quality of life. In this sense, it is suggested that there is no necessary for the certain type of CAF to be restored to sinus rhythm. The influence of CAF on the prognosis of these patients needs furthur studies.

关 键 词：心房颤动 病窦综合征 生活质量 运动耐量 

分 类 号：R541.74[医药卫生—心血管疾病]