右室心尖部与右室中位室间隔部起搏患者心功能及血浆白介素-6水平的比较  

Compare of the effect of right ventricular apex pacing and mid-right ventricular septum pacing on left ventricular function and interleukin-6

作　　者：李文华[1] 邹建刚[1] 何国平[1] 李勇[1] 季建国[1] 周惠芬[1] 黄艳红[1] 

机构地区：[1]江苏省常州市武进人民医院心内科,江苏常州213002

出　　处：《中国心脏起搏与心电生理杂志》2013年第2期142-144,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的比较右室心尖部(RVA)和右室中位间隔部(mid-RVS)起搏对患者左心功能及血浆白细胞介素-6(IL-6)水平的影响,探讨较佳的心室起搏部位。方法将92例植入DDD或DDDR型起搏器患者按起搏部位起搏比例不同分为3组,RVA起搏组(n=35)、mid-RVS组(n=30)和对照组(n=27),RVA组与对照组右室电极置于RVA。mid-RVS组右室电极置于mid-RVS。对比观察三组患者起搏器植入术前及术后6个月左房内径(LAD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、心脏指数(CI)和血浆IL-6水平的变化。结果术前三组LAD、LVEDD、LVEF、IL-6无差异。RVA组术后6个月LAD、LVEDD、IL-6水平明显升高(P<0.05),LVEF和CI有下降趋势。而mid-RVS组、对照组术后6个月患者LAD、LVEDD、LVEF、CI和IL-6水平等指标无明显变化(P>0.05)。RVA组术后6个月与另两组比较,LAD、LVEDD、IL-6水平明显升高(P<0.05),LVEF和CI有下降趋势。结论Mid-RVS起搏较RVA起搏对左心功能和IL-6水平影响较小,是更理想的起搏部位。Objective To study the influence of cardiac pacemaker implantation site on and left ventricu]ar function and plasma interleukin-6 （IL-6）. Methods Ninety-two patients with DDD or DDDR pacing were divided into three groups： right ventrieular apex pacing group （ RVA, n = 35 ） , mid-right ventricular septum pacing group （ mid-RVS , n = 30 ） , and control group（n = 27）. The plasma IL-6 level and left atrial diameter（LAD）, left ventricular end diastolic diameter （LVEDD） , left ventricu]ar ejection fraction（LVEF） , cardiac index （CI） of pre-operation and the sixth month of post-opera- tion were tested. Results In the mid-RVS group and control group, no significant changes were abserved in plasma IL- 6 level , LAD, LVEDD , LVEF or CI from baseline to last follow-up. In the RVA group, plasma IL-6 level, LAD, LVEDD increased significantly at the sixth month （P〈0.05）. In the RVA group, LVEF and CI had down trends at the sixth month. Conclusion Mid-RVS pacing has less impact on plasma IL-6 level and left ventricular function. Mid-RVS is an ideal implantation site.

关 键 词：心血管病学 右室心尖部起搏 右室中位室间隔起搏 白细胞介素-6(IL-6) 心脏指数(CI) 心功能 

分 类 号：R318.11[医药卫生—生物医学工程]