老年人双腔生理性心脏起搏的临床分析  

Clinical analysis of physiologic pacing in elderly patients treated with dual-chamber pacemaker

作　　者：闫明洲[1] 贺玉泉[1] 王文志[1] 魏大愚[1] 吕建莉 

机构地区：[1]吉林大学中日联谊医院心内科,吉林长春130031 [2]长春市第二人民医院

出　　处：《中国老年学杂志》2003年第2期85-86,共2页Chinese Journal of Gerontology

摘　　要：目的　分析双腔生理性心脏起搏治疗老年人缓慢心律失常 ,改善心功能及生活质量的临床效果。方法　 1 998～ 2 0 0 1年为老年人植入双腔生理性心脏起搏器 39例 ,起搏器 DDD型 2 6例 ,DDDR型 1 3例。术后平均随访 0 .5～ 3年 ,随访内容为起搏阈值等参数 ,左室射血分数(L VEF) ,心功能 (NYHA分级法 )及常见并发症 (如充血性心衰、房颤及栓塞等 )。结果　同期老年人双腔生理性起搏器植入率达 2 7.5%～ 49.5% ,术后 LVEF由 (40 .2± 1 6.8) %增至 (48.1± 1 7.2 ) % (P<0 .0 0 1 ) ,心功能平均提高 (1 .2± 0 .3)级以上 (P<0 .0 5) ,运动耐量增加 ,未见常见并发症发生 ,与同期老年人非生理性心室起搏比较 L VEF提高 1 8.2 % (P<0 .0 1 )。结论　双腔生理性心脏起搏能改善缓慢心律失常老年人心功能 ,提高生活质量。Objective To analyze cardiac function and living quality in elderly patients treated with dual chamber pacemaker(DDD/DDDR). Methods 39 patients(pts) of physiologic pacing with DDD(26 pts), DDDR(13pts), and 99 patients of nonphysiologic VVI pacing in the period of 1998～2001. All patients were followed up in a half of～3 years, including LVEF, cardiac function(NYHA class) and living quality. Results For first implantations, dual chamber pacing modes are used in 27.5%～49.5% of cases, cardiac functions were improved in LVEF(40.2%±16.8% vs 48.1%±17.2%, P <0.001) and NYHA class(enhancing 1.2±0.3 class, P <0.05) dual chamber pacing also is better than nonphysiologic VVI Pacing, enhancing LVEF 18.2 %( P <0.01), there are not atrial arrhythmias, congestive heart failure and embolism.Conclusions Physiologic pacing(DDD/DDDR) are much better than nonphysiologic VVI pacing in improving cardiac functions and Living quality in elderly patients.

关 键 词：老年人 生理性心脏起搏 心功能 

分 类 号：R541.72[医药卫生—心血管疾病]