摘要
观察１２例心律失常病人不同频率（７０，９０及１１０ｐｐｍ）ＡＡＩ和ＶＶＩ起搏时的心排出量（ＣＯ）、心脏指数（ＣＩ）、肺毛细血管楔嵌压（ＰＣＷＰ）、肺动脉压（ＰＡＰ）、右房压（ＲＡＰ）和血浆心钠素（ＡＮＰ）、肾素活性（ＰＲＡ）及血管紧张素ＩＩ（Ａ－ＩＩ）的变化。结果显示：ＡＡＩ起搏时，ＣＯ、ＣＩ显著高于ＶＶＩ起博和较慢的自身窦性心律时（Ｐ＜０．０５或０．０１），而无ＶＶＩ起搏所引起的ＰＣＷＰ、ＰＡＰ、ＲＡＰ、ＡＮＰ、ＰＲＡ及Ａ－ＩＩ等显著增高缺点。提示ＡＡＩ起博具有良好的血液动力学效应且不导致心脏内分泌激素异常而优于ＶＶＩ。
Twelve patients with cardiac arrhythmias underwent Swan-Ganz catheterization during pacemaker implanta tion.AAI and VVI pacing were performed consecutively at three pacing rate levels(70,90,110 ppm).Cardiac output(CO),cardiac index(CI).pulmonary capillary wedge pressure(PCWP),pulmonary artery pressure(PAP),right atrial pressure(RAP).atrial natriuretic peptide(ANP).plasma renin activity(PRA)and angiotensin-II (A-II)were measured during different pacing modes and rates.The results showed that AAI pacing caused a significant increase(P<0.05,P<0.01)of CO and CI as compared with VVI pacing and as slower sinus rhythm,no slgnificant changes of PCWP,PAP,RAP,ANP.PRA and A-II were observed.The observation suggested that there could be benefit effects of AAI pacing on hemodynamics but without influence on cardiac endocrine hormone.
关键词
心脏起搏
血液动力学
心钠素
肾素
血管紧张素
cardiac pacing
Hemodynamics
Atrial natriuretic peptide
Renin- angiotensin system
