摘要
目的探讨心脏再同步化治疗(CRT)对慢性收缩性心力衰竭(简称心衰)患者肺功能的影响。方法选取22例行CRT治疗慢性收缩性心衰患者,对比分析术前、术后6个月肺容量:肺总量(TLC)、残气量(RV)、肺活量(VC)、肺泡容量(AV);肺通气功能:用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气流量峰值(PEF)、呼气中期流量(FEF 25%~75%);肺弥散功能:CO弥散量变化,并分析与NYHA心功能分级、体重指数(BMI)、肾小球滤过率(GFR)、脑钠肽、左室射血分数、左房容积、右室收缩压(RVSP)相关性。结果CRT术后肺容量指标:TLC、RV、AV有显著提高[(6.0±1.2)L vs(5.7±1.3)L,(2.7±0.9)L vs(2.5±0.8)L,(4.9±1.0)L vs(4.8±1.0)L,P均<0.05],并与NYHA分级呈负相关(r=-0.35,P<0.05)。通气功能指标:FEF 25%~75%显著提升[(2.7±0.9)L vs(2.5±0.8)L,P<0.05)],与BMI呈负相关(r=-0.53,P<0.05);FVC增加[(3.5±0.6)L vs(3.2±0.8)L,P<0.05)],与BMI(r=-0.35,P<0.05)、RVSP(r=-0.30,P<0.05)呈负相关,与GFR呈正相关(r=0.51,P<0.05)。弥散功能较术前无显著性改变。结论 CRT可增加心功能不全患者肺容量,改善通气功能,但换气功能无明显影响。
Objective To study the effect of cardiac resynchronization therapy （CRT） on pulmonary function in chronic systolic heart failure patients. Methods Variation of lung capacity, pulmonary ventilation function, pul- monary diffuse function were analyzed in 22 heart failure patients undergoing CRT after 6 month, whether pulmona- ry function related with New York Heart Association （NYHA） class, glomerular filtration rate （GFR）, body mass index（BMI）, left ventricular ejection fraction, left atrial volume, right ventricular systolic pressure in those patients was identified. Results Total lung capacity, residual volume, alveolar volume, forced expiratory flow at 25% to 75 % （FEF25 % -- 75 %）, forced vital capacity （FVC） was significantly improved after CRT. The improvement of total lung capacity, residual volume, alveolar volume was inversely correlated with the changes in NYHA class, FEF25M--75% was inversely correlated with the changes in BMI, FVC was inversely correlated with the changes in BMI, right ventricular systolic pressure, but positive with GFR. However, pulmonary diffuse function was not significantly changed. Conclusion CRT can improve lung capacity, pulmonary ventilation function in patients with heart failure.
出处
《中国心脏起搏与心电生理杂志》
2017年第1期20-22,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
心血管病学
心力衰竭
心脏再同步化治疗
肺功能
Cardiology
Heart failure
Cardiac resynchronization therapy
Pulmonary function
