扩张型心肌病患者心脏再同步治疗后发生室性快速性心律失常相关预测因素研究  

Related predicting factors of ventricular tachyarrhythmias after cardiac resynchronization therapy in patients with dilated cardiomyopathy

作　　者：孙辉[1] 陈谦谦[1] 徐勤成[1] 孙晓斐[1] 魏子秀[1] 

机构地区：[1]山东省济宁市第一人民医院心脏中心,济宁272000

出　　处：《临床医学》2014年第5期1-3,共3页Clinical Medicine

摘　　要：目的探讨左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、B型钠尿肽(BNP)、肿瘤坏死因子-α(TNF-α)、胱抑素C(CysC)与扩张型心肌病(DCM)患者心脏再同步化治疗(CRT)后发生室性快速性心律失常的关系。方法选择济宁市第一人民医院行CRT的DCM患者36例,术前行超声心动图检查,静脉血检测BNP、TNF-α、CysC水平;术后随访1年,CRT起搏器记录随访期间持续性室性心动过速(VT)、心室颤动(VF)的发生次数并经程控仪分析。结果共完成随访34例,其中无事件组23例(67.65%),VT/VF组11例(32.35%);两组相比较,仅LVEDD差异有统计学意义(P<0.05),BNP、LVEF、TNF-α、CysC差异均无统计学意义(P>0.05)。结论 LVEDD是DCM患者CRT治疗后发生室性快速性心律失常准确的预测因子,没有发现BNP、LVEF、TNF-α、CysC与此有关。Objective To investigate the relationship between the left ventricular diastolic diameter（LVEDD）,left ventricu-lar ejection fraction（LVEF ）,plasma levels of BNP,TNF-α,Cystatin C（CysC）and ventricular tachyarrhythmia after cardiac resynchronization therapy（CRT）in patients with dilated cardiomyopathy（DCM）. Methods Thirty-six patients with DCM un-derwent CRT in our hospital were chose,and the levels of BNP,TNF-α and CysC were detected. The patients were followed-up for one year,during which the number of consistent ventricular tachycardia（VT）and ventricular fibrillation（VF）were recorded by the CRT pacemaker and analyzed by program recording control instrument. Results Follow-up data were obtained from 34 patients,among them,23 patients（67. 65% ）had no events,11 patients（32. 35% ）had VT or VF. LVEDD level in VT/ VF group was significantly higher than that in the no events group,there were significant differences（P 〈 0. 05）. There were no sig-nificant differences in the levels of BNP,TNF-α,CysC or LVEF（P 〉 0. 05）. Conclusion LVEDD is an accurate predicting factor for ventricular tachyarrhythmia after CRT in patients with DCM. LVEF and plasma levels of BNP,LVEF,TNF-α,CysC were not correlated with ventricular tachyarrhythmia after CRT in patients with DCM.

关 键 词：扩张型心肌病 心脏再同步化治疗 室性快速性心律失常 

分 类 号：R542.2[医药卫生—心血管疾病]