心室自身优先对病态窦房结综合征患者双腔起搏器术后心室起搏比例及血浆BNP水平的影响  

Influence of Ventricular Intrinsic Preferenc Algorithm to Cumulative Ventricular Pacing Proportion and the Level of Serum BNP in Sick Sinus Syndrome Patients with Dual Chamber Pacemaker

作　　者：胡春阳[1] 阳海红[1] 葛慧娟[1] 郭英杰[1] 

机构地区：[1]安徽省阜阳市人民医院心内科,安徽阜阳236000

出　　处：《中国医药指南》2012年第23期419-421,共3页Guide of China Medicine

摘　　要：目的评估双腔起搏器术后心室自身优先(VIP)功能以及不同AV间期延长量下对心室起搏比例(CumVp%)及血浆BNP水平的影响,为临床选择VIP功能中最适AV延长量提供依据。方法选取因病态窦房结综合征(SSS)安置双腔起搏器进行治疗的21例患者,分5次随访进行,每次随访时间间隔为1个月,观察关闭、打开VIP功能以及AV间期延长量为50ms、100ms、200ms时CumVp%及血浆BNP水平的区别。结果与起搏器固定AV间期相比,打开VIP功能使CumVp%及血浆BNP水平降低(P<0.05);AV间期延长量设置为100ms较50ms能进一步降低CumVp%及血浆BNP水平(P<0.01),而设置为200ms在改善CumVp%与100ms时无明显差别(P>0.05),但血浆BNP水平有升高趋势。结论 VIP功能能够有效减少心室起搏,改善血液动力学,100ms的AV间期延长量为最优选择。Objective To investigate the effects of Ventricular Intrinsic Preferenc （VIP） algorithm and different VIP extension on cumulative ventricular pacing proportion（CumVP%） and the level of serum BNP in sick sinus syndrome patients with dual chamber pacemaker. Method A total of 5 followups with the interval of 1 month were carried out among 21 sick sinus syndrome patients after implantation of pacemaker. The function of VIP was dosed, opened, and the VIP extension was set at 50ms, 100ms, 200ms respectively during the follow-up period. Then the CumVP% and the level of serum BNP of each period were observed. Results As compared with fixed AV delay, the CumVP % and the level of serum BNP were reduced（P 〈 0.05） when VIP was opened, and were further reduced（P〈O.Ol） when the VIP extension was set at lOOms compared with that at 50ms. But when the VIP extension was seted at 200ms, no further reduction（P 〉 0.05） of the CumVP% was observed, while the level of serum BNP Was＇slightly increased compared with that at 100ms. Conclusion The VIP function offers further CumVP% reduction and improves the hemodynamics in patients implanted with a dual-chamber pacemaker, especially when the VIP extension was set at 100ms.

关 键 词：病态窦房结综合征 心脏起搏器 永久 AV间期 最小化心室起搏 利钠肽 脑 

分 类 号：R541.7[医药卫生—心血管疾病]