右心室不同部位起搏治疗对高度房室传导阻滞患者心功能的影响  

Effects of Different Parts of Right Ventricular Pacing on Cardiac Function in Patients With High Degree Atrioventricular Block

作　　者：胡彩娜 姜正明[1] 陈魁[1] 

机构地区：[1]郑州大学第一附属医院心血管内科,河南郑州450000

出　　处：《中国卫生标准管理》2016年第21期65-67,共3页China Health Standard Management

摘　　要：目的研究心室不同部位起搏治疗对心功能的影响,为患者选取最佳起搏部位提供临床支持。方法选取2010年3月~2011年10月因持续性III度或高度房室传导阻滞于我院行双腔起搏器植入,且心室起搏率达85%以上的患者66例为研究对象,根据电极导线植入位置不同分为心尖部起搏组A组（34例）、间隔部起搏组B组（32例）;随访5年,对两组患者术前、术后5年新发心律失常、左心房内径（LAD）、左室舒张末期内径（LVEDV）、射血分数（EF）值、血浆脑钠肽（BNP）、QRS波宽度等指标进行比较研究。结果 A组新发心律失常低于B组（P〈0.05）;B组QRS波宽和BNP含量增加幅度低于A组（P〈0.05）;B组LAD、LVEDV、EF值等心室受损程度低于A组（P〈0.05）。结论起搏器植入术后心室高起搏率5年,间隔部起搏对心功能的保护优于心尖部起搏,前者新发心律失常高于后者,前者再次住院率、死亡率均优于后者,具有更高的可靠性和安全性。Objective To study the effect of different parts of ventricular pacing on cardiac function,and to provide the clinical support for selecting the best pacing site. Methods From March 2010 to October 2011 for persistent III degree or high atrioventricular block in our hospital line of dual chamber pacemaker implantation,and ventricular pacing rate was more than 85% of the patients with 66 cases as the research object,according to the position of electrode lead implantation,the patients were divided into apical pacing group A（34 cases）and interval pacing group B（32 cases）. After 5 years of follow-up,（LAD）,left ventricular end diastolic diameter（LVEDV）,ejection fraction（EF）,plasma brain natriuretic peptide（BNP）and QRS wave width were compared between the two groups. Results The arrhythmia of group A was lower than that of group B（P〈0.05）. The amplitude of QRS wave width and BNP content in group B were lower than those in group A（P〈0.05）. Campared with the group A,LAD,LVEDV and EF of the group B were lower（P〈0.05）. Conclusion Pacemaker implantation after ventricular high pacing rate of 5 years,interval pacing heart function protection is better than the apex pacing,the former new arrhythmia higher than the latter,the former re-hospitalization rate,mortality were excellent In the latter,with higher reliability and security.

关 键 词：心脏起搏器 起搏部位 心律失常 心功能 

分 类 号：R541[医药卫生—心血管疾病]