右心室流出道起搏对左心室功能变化的影响  

Effects of Outflow Tract Pacing of Right Ventricle on Left Ventricular Systolic Function

作　　者：艾民[1] 颜昌福[1] 贺剑[1] 夏福纯[1] 周双陆[1] 李翠萍[1] 

机构地区：[1]攀钢集团总医院心内科,四川攀枝花617023

出　　处：《四川医学》2015年第8期1092-1094,共3页Sichuan Medical Journal

基　　金：四川省卫生厅科研课题(编号:130574)

摘　　要：目的探讨右心室流出道部位起搏对患者左心室功能变化的影响。方法选择符合起搏器植入指征患者48例,按照右心室不同起搏部位分为右室心尖部起搏组(RVAP)及右室流出道部起搏组(RVOT),观察两组患者起搏器植入术前及术后12个月血浆BNP水平、心电图QRS波时限、左室收缩末期内径(LVEDV)、左室舒张末期内径(LVESV)、左室射血分数(LVEF)等指标。结果 RVAP组患者术后12个月血浆BNP水平(762±19)pg/m L明显高于术前(561±15)pg/m L(P<0.05),RVOT组患者血浆BNP水平术前(539±13)pg/m L与术后(612±17)pg/m L比较差异无统计学意义(P>0.05);术后RVAP组患者心电图QRS时限最宽(P<0.05),RVOT组患者最窄(P<0.05);术后RVAP与RVOT组患者左心室收缩末期前后径、舒张末期前后径、射血分数与术前比较差异均无统计学意义(P>0.05)。结论选择右心室流出道部位起搏,患者血浆BNP水平最低、起搏QRS时限最窄,可能是理想的右心室起搏部位。Objective To evaluate the effect of outflow tract pacing of right ventricle on the left ventrieular systolic func- tion by comparing. Methods 48 patients with implanted DDD or VVI pacemaker,in accordance with the right ventrieular different pacing sites were randomly divided into two groups：right ventricular apex pacing（RVAP） and right ventricular outflow tract pacing （RVOT）. Plasma BNP, QRS wave duration,left ventricular end systolic diameter （LVESV）, left ventricular end diastolic diame- ter（ LVEDV）, left ventricular ejection fraction（LVEF） were recorded and compared before and 12 months after pacemaker implan- tation. Results Plasma BNP levels were increased in RVAP compared before and 18 months after pacemaker implantation （P 〈 0. 05 ）. There is no statistical difference in RVOT（P 〉 0. 05 ）. Among the two groups, the QRS wave duration was the most widest in RVAP,while the QRS wave duration was the narrowest in RVOT group（ P 〈 0. 05 ）. The LVEDV, LVESV, LVEF were no chan- ges in RVSP or RVOT groups（P 〉 0. 05）. Conclusion The QRS wave duration was narrow and the plasma BNP was lower for the right ventfieular outflow tract pacing. May be the pacing site ideal for patients.

关 键 词：右心室 心尖部起搏 流出道起搏 

分 类 号：R541.7[医药卫生—心血管疾病]