永久性希氏束起搏对患者左心结构及功能的影响研究  

Effect of permanent His-bundle pacing on left ventricular structure and function in patients

作　　者：王罗莎 孙守刚[1] 姜程[1] 吴强[1] 白锋[1] WANG Luosha;SUN Shougang;JIANG Cheng;WU Qiang;BAI Feng(Department of Internal Medicine-Cardiovascular,the Second Hospital of Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学第二医院心内科,甘肃兰州730000

出　　处：《现代医药卫生》2022年第9期1455-1458,共4页Journal of Modern Medicine & Health

基　　金：甘肃省科学技术厅自然科学基金项目(20JR10RA720)。

摘　　要：目的探讨希氏束起搏(HBP)对患者左心结构及功能的影响。方法选取2018年9月至2019年9月该院心内科因高度房室传导阻滞或病态窦房结综合征行永久性起搏器植入术患者47例,将其分为HBP组(23例)和右心室起搏组(24例)。比较2组左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、每分输出量(CO)、美国纽约心脏病学会(NYHA)心功能分级、QRS间期和心室电极参数,以及并发症发生情况。结果2组起搏器植入时及术后1年阻抗比较,差异有统计学意义(P<0.05)。2组起搏器植入时感知比较,差异有统计学意义(P<0.05),但术后1年比较,差异无统计学意义(P>0.05)。2组起搏器植入时及术后1年阈值比较,差异无统计学意义(P>0.05)。2组术后1年LVEF、CO水平及QRS间期比较,差异有统计学意义(P<0.05),而LVEDD水平及NYHA分级比较,差异无统计学意义(P>0.05)。2组并发症发生情况比较,差异无统计学意义(P>0.05)。结论HBP可明显降低LVEDD水平,缩短QRS间期,改善患者左心室收缩功能。Objective To investigate the effect of His-bundle pacing(HBP)on left ventricular structure and function in patients.Methods 47 patients who underwent permanent pacemaker implantation due to high grade atrioventricular block or sick sinus syndrome in the department of cardiology of the hospital from September 2018 to September 2019 were selected and divided into HBP group(23 cases)and right ventricular pacing group(24 cases).The left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),output per minute(CO),New York Heart Association(NYHA)cardiac function grade,QRS interval,ventricular electrode parameters and complications of the two groups were compared.Results There was significant difference in impedance between the two groups at the time of pacemaker implantation and one year after operation(P<0.05).There was significant difference in the perception between the two groups at the time of pacemaker implantation(P<0.05),but there was no significant difference one year after operation(P>0.05).There was no significant difference in the threshold between the two groups at the time of pacemaker implantation and one year after operation(P>0.05).There were significant differences in LVEF,CO levels and QRS interval between the two groups one year after operation(P<0.05),but there were no significant differences in LVEDD level and NYHA grade(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion HBP can significantly reduce the level of LVEDD,shorten the QRS interval and improve the left ventricular systolic function.

关 键 词：希氏束起搏 左心室舒张末期内径 左心室射血分数 

分 类 号：R54[医药卫生—心血管疾病] R5[医药卫生—内科学]