右心室间隔部起搏对永久心脏起搏器植入患者心肌损伤情况、心功能和左心室收缩功能的影响  

Effects of Right Ventricular Septal Pacing on Myocardial Injury,Cardiac Function and Left Ventricular Systolic Function in Patients with Permanent Cardiac Pacemaker Implantation

作　　者：李妍妍 LI Yanyan(Qingyuan People's Hospital,Qingyuan 511500,China)

机构地区：[1]清远市人民医院,广东清远511500

出　　处：《中外医学研究》2024年第5期52-56,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨右心室间隔部起搏对永久心脏起搏器植入患者心肌损伤情况、心功能和左心室收缩功能的影响。方法:选择2019年1月—2021年1月清远市人民医院收治的80例行永久心脏起搏器植入术的患者,按照计算机分组法将其分为心尖组(起搏部位为心尖部)和间隔组(起搏部位为右心室间隔部),各80例。观察两组心肌损伤情况、心功能、左心室收缩功能及同步性、并发症。结果:术后,两组氨基末端脑钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)水平均低于术前,间隔组NT-proBNP、CK-MB水平低于心尖组,差异有统计学意义(P<0.05)。术后,两组心输出量(CO)、左心室射血分数(LVEF)、左室舒张末期内径(LVEDD)均低于术前,间隔组CO、LVEF、LVEDD高于心尖组,差异有统计学意义(P<0.05)。术后,两组收缩末期左心室容积(LVESV)、舒张末期左心室容积(LVEDV)、左心室18节段达峰时间标准差(Tp-SD)、QRS均高于术前,间隔组LVESV、LVEDV高于心尖组,Tp-SD、QRS低于心尖组,差异有统计学意义(P<0.05)。间隔组并发症总发生率为7.50%,与心尖组的12.50%比较,差异无统计学意义(P>0.05)。结论:与心尖部起搏相比,右心室间隔部起搏能减轻植入永久心脏起搏器患者心肌损伤和对心功能的影响,提高左心室收缩功能及同步性,且不增加并发症的发生。Objective:To explore the effects of right ventricular septal pacing on myocardial injury,cardiac function and left ventricular systolic function in patients with permanent cardiac pacemaker implantation.Method:A total of 80 patients undergoing permanent cardiac pacemaker implantation in Qingyuan People's Hospital from January 2019 to January 2021 were selected.According to the computer grouping method,the patients were divided into apical group(pacing site at the apical)and septal group(pacing site at the right ventricular septal),80 cases in each group.Myocardial injury,cardiac function,left ventricular systolic function,synchrony and complications were observed in both groups.Result:After operation,the levels of N-terminal brain natriuretic peptide precursor(NT-proBNP)and creatine kinase isoenzyme(CK-MB)in two groups were lower than before operation,and the levels of NT-proBNP and CK-MB in the septal group were lower than those in the apical group,the differences were statistically significant(P<0.05).After operation,the cardiac output(CO),left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)in both groups were lower than before operation,and the CO,LVEF and LVEDD in septal group were higher than those in apical group,the differences were statistically significant(P<0.05).After operation,end-systolic left ventricular volume(LVESV),end-diastolic left ventricular volume(LVEDV),the standard deviation of 18-segment peak time(Tp-SD)and QRS were higher than those before operation,the LVESV and LVEDV of the septal group were higher than those of the apical group,Tp-SD and QRS were lower than those of the apical group,the differences were statistically significant(P<0.05).The total incidence of complications in the septal group was 7.50%,which was not statistically significant compared with 12.50% in the apical group(P>0.05).Conclusion:Compared with apical pacing,right ventricular septal pacing can reduce myocardial injury and influence on cardiac function in patients with implanted

关 键 词：永久心脏起搏器植入 心尖部 右心室间隔部 心脏同步性 

分 类 号：R654.2[医药卫生—外科学]