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目的探讨右室流入道间隔部起搏对心内膜的影响。方法 64例随机分为右室流入道组(33例)和右室心尖部组(31例),观察起搏前和后1、3个月时的Ⅱ导联QRS波时限、起搏参数(起搏电压域值、电极阻抗)及血浆CKMB(肌酸激酶)、TNI(肌钙蛋白Ⅰ)、MYO(肌红蛋白)水平、IL-6(白介素-6)浓度变化。结果两组起搏参数研究期间均稳定且差异无统计学意义,流入道组QRS时限明显短于心尖组(P<0.05)。两组血浆心肌损伤标志物和IL-6浓度均较起搏前增加(P<0.05),但组间差异无统计学意义,且随时间延长渐降低。结论右室流入道间隔部起搏对心内膜的影响与心尖部起搏相似,但较右室心尖部起搏更符合生理性。
Objective To investigate the effect of right ventricular septum pacing on endocardium. Methods 64 cases were randomly divided into right ventricular inflow group (33 cases) and right ventricular apical group (31 cases). The duration of QRS wave Ⅱ lead, pacing parameter ( Pacing voltage domain and electrode impedance), plasma CKMB (creatine kinase), TNI (troponin I), MYO (myoglobin) and IL-6 (interleukin-6) Results The pacing parameters of both groups were stable and the difference was not statistically significant. The QRS duration of inflow group was significantly shorter than that of apical group (P <0.05). The levels of plasma myocardial injury markers and IL-6 in both groups were significantly higher than those before pacing (P <0.05), but there was no significant difference between the two groups and gradually decreased with time. Conclusion The right ventricular inflow tract septal pacing effect on the endocardium is similar to apical pacing, but more physiologically than right ventricular apex pacing.