病窦综合征患者右心室间隔部起搏比例与心功能的关系  

Relationship between cumulative percent right ventricular septum pacing and cardiac function in sick sinus syndrome patients

作　　者：汤长春[1] 胡美英[1] 向力群[2] 曾向辉[1] 彭珍云[1] 张翼[1] 

机构地区：[1]湖南师范大学第一附属医院心内科,长沙410005 [2]湖南师范大学第一附属医院超声科,长沙410005

出　　处：《中华老年心脑血管病杂志》2011年第9期802-804,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨病窦综合征患者右心室间隔部起搏比例与心功能的关系。方法回顾性分析置入双腔起搏器的病窦综合征患者66例,按术后6个月起搏器程控仪获取的心室起搏比例,将心室起搏比例≥50%作为A组36例和心室起搏比例<50%作为B组30例,比较2组术前与术后血清氨基末端钠尿肽前体(NT-proBNP)和心脏超声检查各参数,并进行相关性分析。结果 2组患者手术前后的心脏超声各参数差异无统计学意义(P>0.05);与术前比较,A组术后NT-proBNP明显升高,B组明显下降(P<0.05),术后A组NT-proBNP高于B组(P<0.05);A组心室起搏比例高于B组[(83.6±3.7)%vs(21.8±6.5)%,P<0.05];NT-proBNP与心室起搏比例呈正相关(r=0.736,P<0.05),与LVEF无相关性(r=-0.11 2,P>0.05)。结论病窦综合征起搏器置入患者中,血清NT-proBNP水平可随心室起搏比例增高而升高,心室起搏比例增高对患者的心功能可产生负面影响。Objective To investigate the relationship between cumulative percent ventricular pacing （Cum%VP） and cardiac function in sick sinus syndrome（SSS） patients with right ventricular septurn pacing. Methods A total of 66 SSS patients with dual-chamber pacemakers were divided into two groups according to Cum% VP at 6 months after implantation of pacemakers. Group A had Cum%VP≥50% （n = 36） ,group B had Cum% VP〈50% （n = 30）. Echocardiographic parameters measured by two-dimensional pulsed Doppler echocardiography and serum NT-proBNP level recorded before and after operation were compared between the two groups. Results There was no difference in all echocardiographic parameters before and after operation between the two groups （P〉 0.05） ;there was also no difference in NT-proBNP between the two groups before operation （P 〉 0.05）. The NT-proBNP in group A was significantly increased after operation compared with before operation, but in group B it was dramatically decreased after operation （P 〈0.05） ,so it was remarkably higher in group A than in B group at 6 months after operation （P〈 0.05）. The Cum%VP in group A was significantly increased compared with group B too （P 〈0.05）. The serum NT-proBNP level was positively correlated with Cum% VP （r = 0. 736,P 〈0.05）. Conclusion The serum NT-proBNP level increases with increases in Cum%VP in SSS patients with pacemakers,increase in Cum%VP may have adverse effect on cardiac function.

关 键 词：病窦综合征 室间隔 心脏起搏器 人工 利钠肽 脑 超声心动描记术 

分 类 号：R541.7[医药卫生—心血管疾病]