论文部分内容阅读
目的探讨右心室不同部位起搏对血浆氨基末端脑钠肽前体(NT-pro BNP)及左心室收缩功能的影响,为患者选择最佳的右心室起搏位置提供临床依据。方法选取2012年3月至2013年3月于本院接受起搏器植入的患者90例为研究对象,根据右心室不同部位起搏将其分为右心室心尖(RVA)起搏组(48例)和右心室间隔部(RVS)起搏组(42例)。对比两组患者术前和术后30天左心室射血分数(LVEF)、左心室后壁厚度(LVPWT)、左心室舒张末期内径(LVEDD)及术后血浆NT-pro BNP水平。结果 RVS组患者术后30天LVEF较术前增加,LVPWT、LVEDD较术前降低;RVA组患者术后30天LVEF较术前减少,LVPWT、LVEDD较术前增加(P<0.05);术后30天RVS组患者LVEF高于RVA组,LVPWT、LVEDD低于RVA组(P<0.05)。术后1年RVS组患者NT-pro BNP水平明显低于RVA组(P<0.05)。结论 RVS起搏较RVA起搏能够更好地降低患者血浆NT-pro BNP水平,并能不同程度地改善患者左心室收缩功能,值得推广应用。
Objective To investigate the effect of pacing in different parts of the right ventricle on the plasma NT-proBNP and left ventricular systolic function in order to provide a clinical basis for selecting the right ventricular pacing position. Methods Totally 90 patients with pacemaker implanted in our hospital from March 2012 to March 2013 were selected and divided into right ventricular apex (RVA) pacing group (48 Cases) and right ventricular septum (RVS) pacing group (42 cases). The left ventricular ejection fraction (LVEF), left ventricular posterior wall thickness (LVPWT), left ventricular end-diastolic dimension (LVEDD) and postoperative plasma NT-pro BNP level were compared between the two groups before and 30 days after operation. Results In the RVS group, the LVEF of the patients in the RVS group was significantly higher than that of the preoperative ones, and the LVPWT and LVEDD of the patients in the RVS group were lower than those before the operation. The LVEF of the RVA group was lower than that of the preoperative 30 days, and the LVPWT and LVEDD were increased (P <0.05) The LVEF of RVS group was higher than that of RVA group on 30 days, LVPWT and LVEDD were lower than that of RVA group (P <0.05). The level of NT-pro BNP in RVS group was significantly lower than that in RVA group at 1 year after operation (P <0.05). Conclusion Compared with RVA pacing, RVS pacing can reduce plasma NT-pro BNP level and improve left ventricular systolic function to some extent, which is worthy of wide application.