完全性房室传导阻滞行起搏器植入术后左心室射血分数下降的影响因素  

Factor related to reduction of left ventricular ejection fraction in patients with complete atrioventricular block undergoing pacemaker implantation

作　　者：程颖[1] 徐超[1] 许莎莎[1] 卢先本[1] CHENG Ying;XU Chao;XU Shasha;LU Xianben(Department of Cardiology,Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University,Taizhou 317000,China)

机构地区：[1]浙江省台州医院心血管内科,317000

出　　处：《浙江医学》2021年第10期1046-1049,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019KY775)。

摘　　要：目的分析完全性房室传导阻滞(CAVB)患者行永久起搏器植入术后左心室射血分数(LVEF)下降的影响因素。方法收集2012年1月至2016年12月因CAVB在浙江省台州医院行永久起搏器植入术、右心室起搏比例≥40%并进行超声心动图、心电图复查的患者130例,将术后LVEF下降(10%及以上)并≤50%的患者作为观察组(20例),无下降者作为对照组(110例)。比较两组患者一般资料及永久起搏器植入前后超声心动图指标[LVEF、左心室舒张末径(LVIDd)]、心电图指标(QRS波群时限),并采用二项logistic回归分析CAVB行永久起搏器植入术后LVEF下降的影响因素。结果观察组冠心病的患病率高于对照组,术前、术后LVEF低于对照组,QRS波群时限大于对照组,术后LVIDd大于对照组,差异均有统计学意义(均P<0.05)。logistic回归分析提示CAVB患者行永久起搏器植入术后LVEF下降与术前LVEF、术后QRS波群时限相关(均P<0.05),与起搏器类型、年龄、是否合并冠心病或瓣膜病、术前QRS波群时限、术前LVIDd均无明显相关(均P>0.05)。结论术前LVEF和术后QRS波群时限是CAVB行永久起搏器植入术后LVEF下降的影响因素。Objective To identify factors related to the reduction of left ventricular ejection fraction(LVEF)in patients with complete atrioventricular block(CAVB)undergoing pacemaker implantation.Methods Clinical data of 130 patients,who underwent pacemaker implantation for CAVB in Taizhou Hospital from January 2012 to December 2016 and presented RV pacing ratio≥40%,were retrospectively analyzed.There were 20 cases with the postoperative LVEF decrease≥10%and LVEF≤50%(observation group)and 110 cases without postoperative LVEF decrease(control group).The factors related to LVEF decrease after pacemaker implantation were analyzed with logistic regression.Results Obervation group has lower baseline LVEF(P<0.05)and longer paced QRS complex duration(P<0.05).Logistic regression analysis showed that baseline LVEF and paced QRS complex duration were independently associated with postoperative LVEF decrease.Conclusion Baseline LVEF and paced QRS complex duration are factors related to the reduction of the LVEF in CAVB patients undergoing pacemaker implantation.

关 键 词：起搏 完全性房室传导阻滞 左心室射血分数 

分 类 号：R541.7[医药卫生—心血管疾病]