不同起搏方式对病态窦房结综合征患者生活质量的长期影响

Long-Term Effect of AAI Pacing and DDD Pacing on Quality of Life in Patients With Sick Sinus Syndrome

目的:本研究旨在评价两种起搏方式[单心房按需(AAI)起搏和双腔按需(DDD)起搏]对患者起搏器植入术后生活质量的长期影响。方法:采用多中心随机对照方法,将患者分入AAI组(57例)和DDD组(86例)。在起搏器植入前、植入后6个月,之后每年1次的随访中,根据随访期间的健康状况填写36条简明健康问卷(SF-36量表)。38例完成3年随访,且SF-36量表资料完整的患者被纳入生活质量研究。结果:与起搏器植入前相比,起搏器植入术后6个月,患者除躯体疼痛稍下降外,生活质量其余各维度均较起搏器植入术前提高,但差异未达到统计学意义;术后1年患者总体健康评分增高,同时AAI组总体健康评分也高于DDD组(P均<0.05);起搏器植入术后2年,起搏器患者生理功能、总体健康、活力及社会功能的评分均较起搏器术前显著增高(P均<0.05);两两比较显示,除了AAI组总体健康评分显著优于DDD组外(P<0.05),两组患者其他各维度的评分差异仍无统计学意义。结论:心脏起搏治疗能明显提高患者的生活质量,而AAI起搏方式对生活质量的改善明显优于DDD起搏方式。

Objective ：To assess the effect of AAI pacemaker and DDD pacemaker implantation on long term quality of life（QOL） in patients with sick sinus syndrome. Methods ： This study randomized two groups of patients with sinus node dysfunction ： AAI pacing group n = 57 and DDD pacing group n =86. Short Form-36（SF-36） was performed pre-implantation,6-month and 1-year after implantation and then annually. 38 cases finished with 3-year follow up,and those who had complete SF-36 were investigated for quality of life. Results：Compared with pre-implantation condition, pacemaker implantation resulted in substantial improvement in almost all QOL measures;1 year after implantation,the patients＇ general condition was improved and AAI group was better than DDD group （ P 〈 0. 05 ）. 2 years after implantation, the role physical（ P =0. 001 ）, general health （ P = 0. 003 ）, vitality （ P = 0. 01 ） and social functioning （P = 0. 046 ）were improved significantly than pre-implantation. By pacing mode analyses, AAI group was obviously better than DDD group in general health condition,but not in other SF-36 subscales. Conclusion：Pacemaker implantation improved health-related QOL and the effect of AAI mode was better than DDD mode.