摘要
目的评价Ⅲ度房室传导阻滞患者植入双腔起搏器后血浆N-末端脑钠肽前体(NTproBNP)水平变化及其与左室射血分数(LVEF)和心室电极起搏部位的关系。方法 69例Ⅲ度房室传导阻滞患者植入双腔起搏器,心室起搏电极放置于右心室流出道间隔部(RVOTS)或右心室心尖部(RVA)。采用固相免疫层析法检测植入术前和术后12个月时的血浆NT-proBNP水平。结果植入双腔起搏器后12个月,患者血浆NT-proBNP较术前下降[(318.1±276.1)pg/ml vs.(339.1±299.7)pg/ml](P<0.05)。LVEF<50%组RVOTS起搏术后12个月NT-proBNP较术前下降[(398.5±247.4)pg/ml vs.(473.5±339.1)pg/ml](P<0.01),但RVA起搏术后12个月NT-proBNP较术前升高[(453.6±365.7)pg/ml vs.(426.5±322.6)pg/ml](P<0.05)。LVEF>50%组的RVOTS或RVA起搏术后12个月NT-proBNP较术前均无明显变化(P>0.05)。结论Ⅲ度房室传导阻滞患者植入双腔起搏器后血浆NT-proBNP水平与术前LVEF和心室电极起搏部位有关。
Objective To investigate the change of plasma N-terminal pro-brain natriuretic peptide（NT-proBNP）after dual-chamber pacemaker（DCP）implantation and its relationship with left ventricular ejection fraction（LVEF）and pacing sites in patients with Ⅲ degree atrioventricular block（AVB）.Methods The DCP implantation was performed in 69 patients with Ⅲ degree AVB.The ventricular electrode was placed on the right ventricular outflow tract septum（RVOTS）or right ventricular apex（RVA）.Plasma level of NT-proBNP was determined by solid phase immune chromatography assay before and in 12 months after DCP implantation.Results Plasma level of NT-proBNP was lower in 12 months after operation than that before[（318.1±276.1）pg/ml vs.（339.1±299.7）pg/ml]（P〈0.05）.Compared with before,plasma level of NT-proBNP in 12 months after operation in the patients with LVEF50% was significantly lower with RVOTS pacing[（473.5±339.1）pg/ml vs.（398.5±247.4）pg/ml]（P〈0.01）,which was significantly higher with RVA pacing[（426.5±322.6）pg/ml vs.（453.6±365.7）pg/ml]（P〈0.05）.Compared with before,plasma level of NT-proBNP in 12 months after operation was not significantly changed in the patients with LVEF〉50% and RVOTS or RVA pacing（P〉0.05）.Conclusion Plasma level of NT-proBNP after DCP implantation is related to LVEF before and ventricular pacing sites in the patients with Ⅲdegree AVB.
出处
《江苏医药》
CAS
北大核心
2014年第21期2541-2544,共4页
Jiangsu Medical Journal
基金
常州市应用基础研究指导性计划(CY20120005)
关键词
Ⅲ度房室传导阻滞
N-末端脑钠肽前体
双腔起搏器植入术
Ⅲ degree atrioventricular block
N-terminal pro-brain natriuretic peptide
Dualchamber pacemaker implantation
