心室间隔部起搏对血浆脑钠肽、心室功能和血流动力学影响的研究  

Study on the effect of ventricular septal pacing on brainpeptide, hemodynamics and ventricular function

作　　者：林德智[1] 

机构地区：[1]内江市第一人民医院心内科,四川省内江市641000

出　　处：《中国心血管病研究》2015年第1期69-71,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨心室间隔部起搏对血浆脑钠肽、心室功能、血流动力学的影响.方法 选择2011年9月至2013年12月在本院植入起搏器的103例患者作为研究对象,按照起搏部位分为观察组（54例）和对照组（49例）.对照组采用右室心尖部起搏,观察组采用右室间隔部起搏.观察两组患者的起搏参数、血浆脑钠肽（BNP）、血流动力学变化.结果 观察组ORS波宽度（QRSD）为（123.96±14.32）ms,低于对照组的（131.58±14.74）ms,差异有统计学意义（P＜0.05）.术后3个月观察组左室射血分数（LVEF）、每搏输出量（SV）、心脏指数（CI）均高于对照组,差异有统计学意义（P＜0.05）.观察组术后12 h、24 h BNP水平均低于对照组,差异有统计学意义（P＜0.05）.两组患者术后房颤发生率比较耒见统计学差异（P＞0.05）.结论 心室间隔部起搏对心室功能影响低于右室心尖部起搏,能更好地保障心脏的收缩功能,临床应加以重视.Objective To investigate the effect of ventricular septal pacing on plasma brain natriuretic peptide, hemodynamics, and ventricular function, and to provide reference for clinical treatment. Methods 103 cases of patients with implanted pacemakers in our hospital from September 2011 to December 2013 were considered as study subjects, in accordance with the pacing site were divided into the observation group（n=54 ） and control group （n=49）, the control group was treated with right ventricular apex pacing, the observation group was treated with right ventricular septal pacing, the pacing parameters, brain peptide （BNP） and hemodynamics were observed between the two groups. Results In the observation group QRSD was （123.96±14.32）ms, lower than （131.58±14.74）ms in the control group, the difference was statistically significant（P〈0.05 ）. After 3 months of the observation group LVEF, SV, CI were higher in the control group, the difference was statistically significant （P〈 0.05）. In the observation group the level of BNP were lower than the control group after 12 hours and 24 hours, the difference was statistically significant （P〈0.05）, Two groups of patients with postoperative atrial fibrillation rate had no significant difference（P〉0.05 ）. Conclusion Effects of ventricular pacing on ventricular function below the right ventricular apical pacing has better protect for the contractile function of the heart, it is worthy of attention.

关 键 词：起搏部位 右室间隔部 右室心尖部 血流动力学 脑钠肽 心室功能 

分 类 号：R541.7[医药卫生—心血管疾病]