左束支区域起搏与右室间隔部起搏治疗房室传导阻滞的效果  

Effect of left bundle branch pacing and right ventricular septal pacing in the treatment of atrioventricular block

作　　者：胡钦 梁洁 周峰 计承 刘金波 韩卫卫 HU Qin;LIANG Jie;ZHOU Feng;JI Cheng;LIU Jinbo;HAN Weiwei(Department of Cardiology,Shijiazhuang People’s Hospital,Hebei Province,Shijiazhuang 050000,China)

机构地区：[1]石家庄市人民医院心内科,河北石家庄050000

出　　处：《中国医药导报》2023年第26期72-75,共4页China Medical Herald

基　　金：河北省医学科学研究课题(20201407)。

摘　　要：目的探讨左束支区域起搏与右室间隔部起搏治疗房室传导阻滞的效果。方法选取石家庄市人民医院2020年6月至2021年6月接受治疗的房室传导阻滞患者88例。采用随机数字表法将其分为对照组和研究组,各44例。对照组给予右室间隔部起搏,研究组给予左束支区域起搏。比较两组心脏功能指标,包括左房前后径、左心室短轴缩短率、左心室射血分数、脑钠肽(BNP)及QRS波群宽度,两组不良反应发生情况。结果术后3个月,两组左心室短轴缩短率、左心室射血分数均高于术前,左房前后径低于术前,且研究组左心室短轴缩短率、左心室射血分数高于对照组,左房前后径低于对照组(P<0.05)。术后3个月,两组BNP低于术前,QRS波宽长于术前,且研究组BNP高于对照组,QRS波宽短于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论与右心室间隔部起搏比较,左束支区域起搏对房室传导阻滞患者心功能的影响更小,尤其对于术前合并心功能不全患者,左束支区域起搏较右心室间隔部起搏心功能改善更明显,临床效果显著,且有效降低不良反应发生情况,值得临床推广及应用。Objective To investigate the effect of left bundle branch pacing and right ventricular septal pacing in the treatment of atrioventricular block.Methods One hundred and twenty-one patients with atrioventricular block treated from June 2020 to June 2021 in Shijiazhuang People’s Hospital were selected,and a total of 88 cases were enrolled after screening.They were divided into control group and study group by random number table method,with 44 cases in each group.The control group was given right septal pacing and the study group was given left bundle branch regional pacing.The cardiac function indexes,including left atrial anterior posterior diameter,left ventricular short axis shortening rate,left ventricular ejection fraction,brain natriuretic peptide(BNP)index,and QRS wave group width,and the occurrence of adverse effects in the two groups were compared.Results Three months after surgery,left ventricular short axis shortening rate,left ventricular ejection fraction in the two groups were higher than those before surgery,and left atrial anterior and posterior atrial diameter was lower than those before surgery,and left ventricular short axis shortening rate,left ventricular ejection fraction in study group were higher than those of control group,and left atrial anterior and posterior atrial diameter were lower than those of control group(P<0.05).Three months after operation,BNP levels in two groups were lower than those before operation,QRS wave widths were longer than those before operation,BNP in study group was higher than that of control group,QRS wave width was shorter than that of control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with pacing in the right ventricular septum,the left bundle branch region pacing has less effect on cardiac function in patients with atrioventricular block,especially in patients with preoperative heart dysfunction,pacing in the left bundle branch region has more obvious improv

关 键 词：右室间隔部起搏 左束支区域起搏 房室传导阻滞 临床效果 

分 类 号：R541[医药卫生—心血管疾病]