再同步化治疗对改善左室舒张末期内径疗效的分析  

Analysis on improvement of left ventricular end diastolic diameter after cardiac resynchronization therapy

作　　者：魏钟海[1] 李晓宏[1] 蓝荣芳[1] 徐伟[1] 

机构地区：[1]南京大学医学院附属鼓楼医院心内科,江苏南京210008

出　　处：《实用临床医药杂志》2013年第1期13-16,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨对再同步化治疗(CRT)后左室舒张末期内径(LVEDd)改善有影响作用的因素。方法选取在鼓楼医院成功植入CRT的43例患者,搜集其术前、术后6个月随访的资料,通过相关性分析、t检验、方差分析、多元回归分析,筛选出最能影响术后LVEDd改善程度的因素。结果单因素分析显示,年龄、病程,基础心电图的QRS时限、是否患有高血压、糖尿病,性别,是否为缺血性心肌病,术前的LVEDd,术前心电图是否为左束支传导阻滞,左室电极的位置,二尖瓣返流程度均对LVEDd的改善程度无显著的影响。多元线性回归分析显示,术前LVEDd、性别、是否有糖尿病3个因素与LVEDd的改善程度线性相关,其回归系数分别为-0.17(P=0.026)、-0.23(P=0.052)和-0.18(P=0.084)。结论术前的LVEDd、性别、糖尿病史与术后LVEDd改善程度线性负相关,相关程度较弱,但具有一定的预测作用。Objective To explore the factors which can impact the improvement of left ven- tricular end diastolic diameter （LVEDd） after cardiac resynchronization therapy （CRT）. Methods Forty-three patients who suffered from chronic heart failure and were implanted CRT in our hospital were enrolled in the study. Data of preoperative period and six months after CRT were collected. Several statistic methods, such as correlation analysis, t-test, ANOVA, multivariate regression anal- ysis, were used to identify which factor could influence the improvement of LVEDd. Results Sin- gle factor analysis demonstrated that age, duration of disease, preoperative QRS wave duration of preoperation, hypertension, diabetes, sex, ischemic cardiomyopathy, LVEDd of preoperation, left bundle branch block, electrode position of left ventricular and the extent of mitral regurgitation did not impact the improvement of LVEDd significantly. However, multivariate regression analysis re- vealed that LVEDd of preoperation, sex and diabetes history were linear correlated with improve- ment of LVEDd. The regression coefficient were - 0.17（P = 0. 026）, - 0.23（P = 0. 052） and - 0.18 （P = 0. 084） respectively. Conclusion The LVEDd of preoperation, sex and diabetes history are negative linear correlated with improvement of LVEDd after CRT, which can have predictive value, although the relation is weak.

关 键 词：再同步化 左室舒张末期内径 改善 线性相关 

分 类 号：R541[医药卫生—心血管疾病]