摘要
目的:探讨右心室流出道(right ventricular outflow trace,RVOT)间隔部起搏QRS波时限对缓慢型心律失常伴有心功能不全患者心脏收缩功能的影响。方法:选取采用右心室间隔部起搏治疗,心室起搏比例均大于90%,并且术前合并心功能不全的患者52例。按患者起搏时QRS波时限(paced QRS duration,p QRSd)分为两组,QRS波时限<180 ms的为A组(n=26),起搏时QRS波时限≥180 ms的为B组(n=26)。测量并比较起搏器植入前和术后3个月两个不同时期的血浆N端-B型脑钠肽原(NT-proBNP)、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、起搏参数变化。结果:术前两组的NT-pro-BNP值和心脏超声指标比较,差异均无统计学意义(P>0.05);术后3个月B组的NT-pro-BNP、LVEDD、LVESD指标均明显高于A组,B组的LVEF低于A组,差异均有统计学意义(P<0.05);起搏器置入时、术后3个月两组患者起搏阀值、导线阻抗、R波高度等比较,差异均无统计学意义(P>0.05)。结论:对于伴有心功能不全并且需要安装心脏永起搏器的患者,RVOT间隔部起搏QRS波时限和术后心功能密切相关,p QRSd越宽,心功能越差。
Objective：To observe the effects of paced QRS duration（p QRSd） on cardiac function in right ventricular outflow tract（RVOT） pacing patients who have slow arrhythmia requiring permanent pacemaker therapy associated with cardiac dysfunction.Method：52 patients associated with cardiac dysfunction,performed with right ventricular outflow tract paced,and the percentage of ventricular paced were greater than 90%,they were divided into A group（p QRSd〈180 ms） and B group（p QRSd ≥ 180 ms）.NT-pro-BNP、LVEDD、LVESD、LVEF were analyzed and compared between two groups immediately after operation and 3 months after operation and observed the changes of cardiac function in patients.Result：NT-pro-BNP and cardiac ultrasound index of the two groups before operation were not statistically significant differences（P〈0.05）.After operation 3 months,the NTpro-BNP,LVEDD,LVESD indexes of B group were significantly higher than those in A group,and the LVEFgroup of B was lower than A group,the differences were statistically significant（ P〈0.05）.During pacemaker implantation, 3 months after surgery,two groups of patients with pacing threshold and lead impedance,R wave height,there were no significant differences（ P〉0.05）.Conclusion：Patients with heart failure and need to be fitted with permanent cardiac pacemaker,RVOT interval paced QRS duration and postoperative cardiac function are closely related,p QRSd is wider,the heart function is poorer.
出处
《中国医学创新》
CAS
2016年第30期46-49,共4页
Medical Innovation of China
基金
莆田市科技计划项目(2008 ZS 01)
莆田市医学科技项目[2008S01(3-11)]
关键词
心功能不全
右室流出道
QRS波时限
Cardiac dysfunction
Right ventricular outflow trace
Paced QRS duration
