心脏再同步化起搏治疗对慢性充血性心力衰竭患者心脏重构的影响  

Effect of cardiac resynchronization therapy on left ventricular remodeling in patients with chronic congestive heart failure

作　　者：李驰 胡昌兴[1] 李庆宽[1] 覃绍明[1] 刘伶[1] 徐广马[1] 伍广伟[1] 林英忠[1] 

机构地区：[1]广西壮族自治区人民医院心内科,南宁530021

出　　处：《中国临床新医学》2017年第9期842-844,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西壮族自治区卫计委重点课题(编号:桂卫重2012110)

摘　　要：目的观察心脏再同步化起搏治疗(cardiac resynchronization therapy,CRT)对慢性充血性心力哀竭(chronic congestive heart failure,CHF)患者心脏重构的影响。方法入选21例CHF患者中扩张型心肌病13例,缺血型心肌病8例。所有患者符合CRT指南的Ⅰ类适应证。观察患者行CRT术后6个月及12个月左室射血分数(LVEF)、左室舒张末内径(LVDD)、左室收缩末内径(LVDS)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及左心房内径(LAD)的变化。结果 CRT术后6个月和12个月LVEF较术前显著增加(P<0.05);LVDD、LVDS、LVEDV、LVESV及LAD较术前显著减少(P<0.05)。术后12个月与术后6个月比较,以上指标差异均无统计学意义(P>0.05)。结论 CRT术后6个月即可显著逆转CHF患者左室心肌重构,提高射血分数。Objective To investigate the effect of cardiac resynchronization therapy（CRT） on left ventricular remodeling in patients with chronic congestive heart failure（CHF）.Methods 21 CHF patients who were in accordance with the guidelines for class Ⅰ indication were enrolled, of whom 13 cases suffered from dilated cardiomyopathy and 8 cases suffered from ischemic cardiomyopathy. Left ventricular ejection fraction（LVEF）, left ventricular end diastolic diameter（LVDD）, left ventricular end systolic diameter（LVDS）, left ventricular end diastolic volume（LVEDV）, left ventricular end systolic volume（LVESV） and left atrium diameter（LAD） were observed 6 and 12 months after the CRT.Results Compared with those before the CRT, the LVEF was increased significantly and the LVDD, LVDS, LVEDV, LVESV and LAD were decreased significantly 6 and 12 months after the CRT（P〈0.05）. There were no significant differences in all the above parameters between 6 months and 12 months after the CRT（P〉0.05）.Conclusion CRT can significantly reverse left venticular remodeling and increase LVEF in the patients with CHF 6 months after the operation.

关 键 词：心脏再同步化治疗 慢性心力衰竭 左室重构 

分 类 号：R541.61[医药卫生—心血管疾病]