非生理性起搏与生理性起搏患者血浆脑钠素的变化及其意义

Changes of Plasma Brain Natriuretic Peptide and It's Impact in Patients with Physiological and Non - physiological Pacing

目的:为弄清不同起搏模式对血浆脑钠素(BNP)水平影响的差异及意义。方法:选择门诊进行随访的已安置起搏器的病人57例,按起搏方式分为生理性起搏组(n=23例)和非生理性起搏组(n=34例),另选同期进行体检健康者20例作为对照组,测定其血浆BNP水平、超声心动图指标。结果:非生理性起搏组BNP浓度高于生理性起搏组和组照组[(89.34±25.11) pg/ml vs(56.33±47.62)pg/ml,(30.35±8.51)pg/ml,P均<0.01];生理性起搏组BNP浓度高于对组照组(P<0.01);非生理性起搏组射血分数明显低于生理性起搏组及对照组[(0.44±0.12)vs(0.56±0.07),(0.65±0.10),P均<0.01),生理性起搏组EF又明显低于对照组(P<0.01)。结论:起搏会引起BNP升高,尤以非生理起搏最明显,此与心功能水平有关。

Objective:To explore the changes of plasma brain natriuretic peptide(BNP) and it's impact in patients vvith physiological and non - physiological pacing.Methods:The subjects consisted of 57 outpatients with implanted pennanent pacemakers for at least 6 months.They were divided into the physiological pacing group(DDD,n = 23)and non - physiological pacing group(VVI,n = 34). 20 cases healthy persons were elected as the control group. Plasma BNP were measured and echocardigrams were also taken. Results: Plasma BNP level was significantly higher in the non - physiological pacing group than in the physiological pacing group and in the control group [ (89. 34±25. 11) pg/mlvs (56. 33±47.62) pg/ml, (30.35±8.51) pg/ml, allP < 0.01] .It was also significantly higher in the physiological pacing group than in the control group (P < 0.01). Left ventricular ejection fraction (LVEF) was significantly lower in the non - physiological pacing group than in the physiological pacing group and in the control groupt (0.44±0.12) vs (0.56±0.07), (0.65±0.10), all P<0.01]. It was also significantly lower in the physiological pacing group than in the control group (P < 0.01) .Conclusion: Pacing could elicit high plasma BNP,especially in the patients with non - physiological pacing and it could be correlated vvith bad LVEF.