双腔起搏器更换三腔起搏对长期右心室心尖起搏后老年心力衰竭患者左心功能影响  

Effect of dual-chamber pacemaker replaced with three-chamber pacing on left ventricular function in elderly patients with heart failure after long-term right ventricular apical pacing

作　　者：阿拉腾其木格 俞波 Alatengqimuge;Yu Bo(Heart Center,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010017,China)

机构地区：[1]内蒙古自治区人民医院心脏中心

出　　处：《中华保健医学杂志》2019年第5期417-420,共4页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨双腔起搏器更换三腔起搏对长期右心室心尖起搏后老年心力衰竭患者左心功能影响。方法选取97例植入双腔起搏器后出现心力衰竭的患者,统计分析三腔起搏器植入前及植入术后1、3和6个月,术后1年、2年的心功能参数、纽约心脏协会(NYHA)心功能分级、QRS间期及血清脑钠肽(BNP)各指标的变化。结果更换三腔起搏器后1个月左室射血分数(LVEF)、NYHA心功能分级及QRS波宽度显著优于植入前,差异有统计学意义(P<0.05);而LVEF、左心房面积(LA),左室舒张末内径(LVEDD),左室舒张末容积(LVEDV),左室收缩末期内径(LVSD),左室收缩末容积(LVESV)、QRS波宽度之间差异无统计学意义;更换三腔起搏器术后3个月、6个月、1年及2年的LVEF较植入前明显提高,而LVEDD、LADD、LVEDV、LVESV、LVSD均较植入前明显减小,差异有统计学意义(P<0.05)。所有患者出院后3个月、6个月、1年、2年时NYHA心功能分级、QRS波宽度、6 min步行实验距离及血清BNP较术前显著改善,差异有统计学意义(P<0.05)。结论双腔起搏器更换为三腔起搏器有助于改善右心室心尖起搏后发生心衰的老年患者的心功能。Objective To investigate the long-term effect of dual-chamber pacemaker replaced with three-chamber pacing on left ventricular function in elderly patients with heart failure after right ventricular apical pacing.Methods Ninety-seven patients with heart failure after implantation of a double-chamber pacemaker were enrolled.Cardiac function parameters,New York Heart Association(NYHA)cardiac function grading,QRS interval,and brain natriuretic peptide(BNP)changes were analysed before and at 1 months,3 months,6 months,1 year and 2 years after replacement of the three-chamber pacemaker.Results At 1 month after upgrading the three-chamber pacemaker,the LVEF,NYHA cardiac function grading and QRS wave width were significantly better than those before implantation.There was no significant difference between the LVEDD,LVEDV,LVESV,LA,LVSD and QRS wave widths before and after the upgrade.The LVEF at 3 months,6 months,1 year and 2 years after the replaced with the three-chamber pacemaker was significantly higher than that before transplantation,while LVEF、LVEDD,LADD,LVEDV,LVESV and LVSD were significantly lower than before transplantation.NYHA cardiac function grading,QRS wave width,six-minute walking distance and serum BNP were significantly improved after 3 months,6 months,1 year,and 2 years.Conclusions The upgrade of a dual-chamber pacemaker replaced with a three-chamber pacemaker helps improve cardiac function in elderly patients with heart failure after right ventricular apical pacing.

关 键 词：双腔起搏器 右心室心尖起搏 老年 心力衰竭 

分 类 号：R654.2[医药卫生—外科学]