心脏再同步治疗患者肺动脉压力的变化  

Systolic pulmonary artery pressure changings in patients with cardiac resynchronization therapy

作　　者：沈伟[1] 陈康玉[1] 王玉婷[1] 苏浩[1] 朱红军[1] 孙贤林[1] 安春生[1] 范西真[1] 徐建[1] 严激[1] 

机构地区：[1]安徽医科大学附属省立医院心内科,安徽合肥230001

出　　处：《中国心脏起搏与心电生理杂志》2015年第4期291-294,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨接受心脏再同步治疗或加除颤器(CRT/CRT-D)的患者肺动脉压力(SPAP)的变化情况。方法入选136例接受CRT/CRT-D植入的患者,术后随访12个月,在3、6、12个月分别行超声心动图检查,测量左室舒张期末径(LVEDD)、左室射血分数(LVEF)和SPAP,术后3个月根据LVEDD和LVEF数值判断有无反应性,并按有无反应性分成2组,比较两组对应时段SPAP变化情况。结果入选病例中有反应者101例,占74.3%;无反应者35例,占25.7%,其中4例在一年内死亡。样本SPAP呈非正态分布,样本均数采用中位数、4分位间距表示,即:M(P25,P75)。有反应病例中术前平均SPAP与无反应病例差异无统计学意义;术后第3、6、12个月SPAP较无反应组分别降低5mm Hg、17 mm Hg和25 mm Hg,两组SPAP数值差异有统计学意义,P值均小于0.001。结论心脏再同步治疗有反应病例术后SPAP减低,且随着随访时间的延长,降低幅度会进一步增加;而无反应病例术后SPAP上升,且随着病程的延长,上升幅度会进一步增加。Objective To explore the systolic pulmonary artery pressure （SPAP）altering in patients accepted cardiac resynchronization therapy or plus defibrillator （ CRT / CRT-D） . Methods One hundred and thirty six patients who ac- cepted CRT / CRT-D implantation envolled. 110 male and 26 females, aged 58.5± 10.9 and 61.3 ± 9.3 years old respec- tive , followed up for 12 months. At 3th,6th, 12th month, all patients were performed echocardiography such as left ventricu- lar end-diastolic dimension （LVEDD） ,left ventricular ejection fraction（LVEF） and SPAP. Patients were divided into two groups by response to CRT or not accoding to LVEDV and LVEF. Comparison SPAP of the two groups each corresponding alters in each period. Results In these cases, there were 101 responders, accounting for 74.3% ; 35 nonresponders accounting for 25.7%. Due to non-normal distribution of samples, sample mean using median,4 quartile interval, ie：M （P25, P75 ）. There were no significant difference in the two groups of mean SPAP before CRT. And at 3th,6th, 12th month followed up, SPAP in response group decreased 5,17,25 mmHg than non response group respectively . There were signifi- cant difference in two groups corresponding period SPAP（ P〈0. 001 ）. Conclusions SPAP reduced in response group in patient underwent CRT/CRT-D. And with longer follow-up, reducing the amplitude will further. Those increased in non-re- sponse group. And with longer follow-up, increasing the amplitude will further too.

关 键 词：心血管病学 心脏再同步治疗 肺动脉压力 有反应 无反应 

分 类 号：R318.11[医药卫生—生物医学工程]