摘要
目的观察右心室不同起搏位点对QRS波群间期的影响，并分析其对心功能的影响。方法将我院2012年1月至2013年1月行间隔部起搏双腔起搏器植入的50例患者作为A组，从我院既往行心尖部起搏双腔起搏器植入术的患者中选择性别、年龄、病情等与之匹配的100例患者作为B组，采用1：2配对研究，分析两种起搏位点对QRS波群的影响，并比较两组随访1年时的心排血量（CO）、每搏输出量（SV）、射血分数（EF）、左室舒张末内径（LVEDD）和BNP的变化。结果A、B两组在年龄、性别、疾病构成、起搏器类型、基础QRS波宽度等方面无明显差别。术后A组的QRS波宽度明显比B组短[（150．93±20．71）ms比（182．22±18．00）ms，P〈0．05]；术前A、B两组的CO、SV、EF、LVEDD及BNP无明显差别，而随访1年时A组的CO、SV、EF明显高于B组[CO（3．63±0．09）L／min比（3．13±0．07）L／min，SV（68．83±3．99）ml比（60．65±3．53）ml，EF（60．57±3．28）％比（53．50±3．79）％]，而A组的BNP水平及LVEDD明显低于B组[BNP（56．13±18．36）pg／ml比（77．02±16．15）pg／ml，LVEDD（43．68±5．17）mm比（46．13±3．07）mm]，差异具有统计学意义。结论右心室间隔部起搏的QRS波时限明显低于心尖部起搏组，并且间隔部起搏可获得更好的血流动力学预后。
Objective To investigate the effects of different right ventricular pacing sites on the QRS time and to analyze its impact on cardiac function. Methods 50 Patients enrolled in our hospital （2012.1-2013.1） who undergo septum pacing with dual-chamber pacemaker implanted as group A. 100 patients who underwent api- cal pacing with dual-chamber pacemaker implanted whose gender, age and condition matched as a group B. The impact of two pacing sites on the QRS time, and compared cardiac output （CO）, stroke volume （SV）, ejection fraction （EF）, left ventricular end-diastolic diameter （LVEDD） and changes in the BNP were compared after 1- year follow-up time. Results A, B show no significant difference in age, sex, disease constitute,pacemaker type, and the basis QRS width. After the surgery, QRS width was significantly shorter in group A than group B [ （ 150.93±20.71 ）ms vs （ 182.22±18.00）ms, P〈0.05 ]. Preoperative CO, SV, EF, LVEDD and BNP had no sig- nificant difference between two groups, but after l-year follow-up the CO, SV, EF in A group were significantly higher than in group B[CO（3.63±0.09）L/min vs （3.13±0.07）L/min, SV（68.83±3.99）ml vs （60.65±3.53）ml, EF （60.57±3.28）% vs （53.50±3.79）% ], while LVEDD and BNP levels were significantly lower than in group B [BNP（56.13±18.36）pg/ml vs （77.02±16.15）pg/ml, LVEDD（43.68±5.17）mm vs （46.13±3.07）mm]. Conclusion QRS wave duration in the septum pacing group are significantly lower than apical pacing and septum pacing lead for better hemodynamic prognosis.
出处
《中国心血管病研究》
CAS
2015年第7期632-635,共4页
Chinese Journal of Cardiovascular Research
