右室流入道间隔部起搏对心脏结构和功能的远期影响  

Long-Term Influence of Pacing Right Ventricular Inlet Septum on Heart Function and Structure

作　　者：邹宝明[1] 王景武[1] 徐敏[1] 孙克陆[1] 何传飞[1] 何立峰[1] 

机构地区：[1]解放军第105医院四病区心内科,合肥市230031

出　　处：《中华全科医学》2012年第10期1522-1523,1540,共3页Chinese Journal of General Practice

摘　　要：目的探讨右室流入道间隔部(RVIS)起搏对心脏结构和功能的远期影响。方法比较RVIS组(82例)和(右室心尖部)RVA组(53例)植入起搏器4年后,左房内径(LAD),左室舒张末内径(LVED),右室舒张末内径(RVED),三尖瓣返流率(Tricuspid regurgitation rate,TRR),三尖瓣返流面积(Tricuspid regurgitation area,TRA)及左心室(VpkA)右心室(VpkP)收缩功能的变化。结果两组患者电极稳定起搏有效,两组患者LAD,LVED,RVED均有增加,但仅RVA组RVED增大显著(P<0.05);RVA组TRR及TRA显著增加(P<0.01),RVIS组仅TRR显著增加(P<0.05);两组相比,RVA组的TRR及TRA增加显著(P<0.05);RVA组VpkA(P<0.01),VpkP(p<0.05)显著下降,RVIS组该指标变化不明显,两组相比,RVA组VpkA下降更明显(P<0.05)。结论 RVIS起搏较RVA起搏对心脏结构和功能的远期保护更好,更符合生理性。Objective To investigate the long-term influence of pacing right ventricular inlet septum（RVIS） on heart function and structure. Methods VVI pacing was performed in 82 patients RVIS and 53 patients right ventricular apex （RVA）. The changes of electrode stability, left atrium dimension （ LAD）, left ventricular end-diastolic dimension （ LVED）, right ventricular end-diastolic dimension （ RVED）, Tricuspid regurgitation rate （ TRR）, Tricuspid regurgitation area （ TRA）, and left or right ven- tricular contraction were compared. Results The pacing electrodes were all steady in their positions in both groups. The LAD LVED and RVED were increased in both groups, but RVED only in Group RVA had more obvious increasing （P 〈 0.05 ）. The TRR and TRA in Group RVA were increased significantly（P 〈 0.01 ）. Only the TRR in Group RVIS were increased significantly （P 〈 0.05）. The TRR and TRA in Group RVA were increased significantly（ P 〈0.05）. There was no obvious change for VpkA and VpkP in RVIS. However, VpkA （P 〈 0.01 ） and VpkP（ P 〈 0.05 ） in Group RVA were decreased significantly. Compare two groups, VpkA was decreased obviously in Group RVA （P 〈 0.05 ）. Conclusion The RVIS pacing is much safer and more effective than RVA pacing showed by the long-term follow-up, moreover,it is more consistent with the physiological ventricular activa- tion sequence.

关 键 词：心脏起博器 人工 右心室流入道间隔部 心功能 心脏结构 长期随访 

分 类 号：R541[医药卫生—心血管疾病] R540.4[医药卫生—内科学]