摘要
目的 观察老年病态窦房结综合征患者,植入频率适应性起搏器后生活质量、心脏功能及运动耐量等改变,以探讨频率适应性起搏器对老年患者生活质量的影响。方法 经临床、食管心房调搏、动态心电图和运动试验心电图确诊病态窦房结综合征且合并窦房结变时功能不良的30例老年患者,择期植入永久双腔频率适应性起搏器(DDDR),于起搏器植入术后即刻及12个月后将起搏器分别程控为非频率适应性起搏模式(DDD)和频率适应性起搏模式(DDDR)。两种模式下起搏器各工作12个月,定期随访,采用SF-36生活质量调查表,进行问卷调查;动态心电图监测24h日常活动时心率变化;症状限制性活动平板运动试验观察运动持续时间,最大起搏频率;超声心动图测定最大运动负荷时每搏量、每分心排出量。结果 本组患者DDDR模式下SF-36调查表的总得分118.60±7.12比DDD模式下该表总得分95.27±7.56提高了24%,P〈0.001,生活质量较DDD模式有显著提高;运动持续时间和最大心排出量均较DDD模式明显增加[(386.20±67.72)s vs(274.10±56.88)s,P〈0.001;(9.97±1.03)/min vs(6.30±0.79)/min,P〈0.001]。结论 频率适应性起搏器可明显改善老年病态窦房结综合征患者的生活质量和运动耐量。
Objective To investigate the effect on Quality-of-Life(QOL) of rate adaptive pacemaker in old patients with sick sinus syndrome(SSS). Methods Thirty old patients with SSS in terms of clinical manifestation, Holter and tread mill underwent the dual chamber pacing(DDDR). Pacemakers were respectively programmed without and with adaptive demand mode in the implantation instantly and 12 months later. The SF- 36 was used to measure the quality of life without and with adaptive demand mode, and the pacing rate, cardiac out-put and exercise capacity were measured by tread mill, echocardiography and Holter during exercise test and daily activities in two different modes. Results The scores of SF-36 were significantly increased ( 118.60 ± 7. 12 vs 95.27 ± 7.56, t = 12. 31, P 〈 0. 001 ) in DDDR mode. The scores about five aspects of SF-36, which included physical functioning, physical role, general health, vitality and social functional were better than those in DDD mode( except for body pain, emotional role and mental health). Compared with DDD mode, the exercise time and cardiac out-put of 30 patients were significantly increased [ ( 386. 20 ± 67. 72 ) s vs (274.10±56.88)s, t=6.94, P〈0.001; (9.97 ±1.03)/min vs (6.30 ±0.79)/min, t =15.41, P〈 0. 0011. However, there were no significant difference between the tow modes in the stroke volume [ (71.57 ± 5. 35 ) ml vs ( 70. 67 ± 5.42 ) ml, t = 0. 65, P = 0. 52 ]. Conclusion The implantation of DDDR improves health-related quality of life, meets with requirement of life in the elderly patient with sick sinus syndrome.
出处
《中华心律失常学杂志》
2007年第1期71-74,共4页
Chinese Journal of Cardiac Arrhythmias