右心室不同部位起搏早期对患者血浆肿瘤坏死因子-α的影响  

Influence of Cardiac Pacemaker Implantation Site on Plasma Tumor Necrosis Factor

作　　者：马剑芬[1] 李学文[2] 王雄[2] 吕吉元[2] 王群[2] 刘向东[2] 赵太生[2] 吴萍[2] 

机构地区：[1]山西医科大学 [2]山西医科大学第一附属医院

出　　处：《中西医结合心脑血管病杂志》2010年第5期536-538,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的比较右心室心尖部(RVA)和右心室间隔部(RVS)不同部位起搏早期对患者血浆肿瘤坏死因子(TNF-α)水平的影响。方法将25例植入DDD型起搏器患者随机分为3组,RVA起搏组、RVS起搏组、对照组,对比观察3组患者植入起搏器前及术后3个月血浆TNF-α的变化。结果术前3组患者血浆TNF-α水平比较差别无统计学意义(P>0.05);术后一周3组患者血浆TNF-α水平两两比较差别无统计学意义(P>0.05);术后3月RVA起搏组与术前、术后一周比较TNF-α水平,差别有统计学意义(P<0.001),即RVA起搏组患者血浆TNF-α水平随时间增加而增加;RVS起搏组较术前、术后一周TNF-α水平比较,差别无统计学意义(P>0.05);RVA起搏组较RVS起搏组TNF-α水平升高,差别有统计学意义(P<0.001)。结论右心室间隔部起搏较右心室心尖部起搏更有利于双心室电激动的同步性,且对心功能的影响较小,右心室间隔部起搏是安全、有效的。Objective To study the influence of cardiac pacemaker implantation site on plasma tumor necrosis factor-alpha（TNF-α）.Methods Twenty-five patients with DDD pacing were divided into three groups：Right ventricular septum pacing group（RVS,n=9）,right ventricular apex pacing group（RVA,n=9）,and control group（n=7）.The plasma TNF-α levels were tested.Results There were no differences of TNF-α in control group,RVA group and RVS group pre-operation.There were no statistical significance of TNF-α between three groups after one week of operation.The plasma TNF-α levels in RVA pacing group three months after operation was higher than that preoperation（P0.01）.There were no statistical significance in RVS pacing group at preoperation,one week after operation and three months after operation.TNF-α in RVA pacing group was higher than that in RVS pacing group at three months after operation（P0.01）.Conclusion Compared with the RVA pacing,the TNF-α in RVS pacing were more conducive to double ventricular electrical synchronization of excitement,and less impact on cardiac function.RVS pacing was safe and effective.

关 键 词：右心室间隔部起搏 右心室心尖部起搏 肿瘤坏死因子TNF-Α 

分 类 号：R541.7[医药卫生—心血管疾病]