永久性心脏起搏对血浆脑钠尿肽的影响及贝那普利的干预作用

Effect of permanent cardiac pacing on brain natriuretic peptide and the intervention of benazepril

目的：研究不同起搏模式、不同心室起搏百分比对永久性心脏起搏患者血浆脑钠尿肽（BNP）浓度的影响,及贝那普利对该类患者心功能的干预作用。方法：入选2006年1月~2007年10月于我院行永久性心脏起搏的患者120例,其中VVI起搏62例DDD起搏58例,所有患者随机分为服用贝那普利组（干预组）及未服用贝那普利组（非干预组）,每组根据起搏模式不同分为VVI起搏亚组及DDD起搏亚组。分别于起搏前、起搏后6个月检测血浆BNP浓度。结果：VVI起搏患者血浆BNP浓度大于DDD起搏患者（P〈0.05）;高心室起搏百分比患者血浆BNP浓度大于低心室起搏百分比患者（P〈0.05）;干预组血浆BNP浓度显著低于非干预组（P〈0.05）。结论：起搏后血浆BNP浓度增加,且随着心室起搏百分比的增高而增高,但DDD起搏优于VVI起搏;贝那普利可以延缓永久性心脏起搏患者血浆BNP浓度的增加量。

AIM ： To investigate the effect of different pacing modes and different cardioventricular pacing percentage on the plasma concentration of brain natriuretic peptide （BNP） and the intervention of benazepril in the pacemaker population. METHODS： One hundred and twenty patients [ ventricular inhibited （VVI） 62, dual-mode, dual-pacing, dual-sensing （DDD） 58 ] implanted with permanent cardiac pacing from January 2006 to October 2007 in our hospital were enrolled in the study. Patients were randomized to two groups according to whether or not they were taking benazepril. Each group was subdivided into DDD group and VVI group. Plasma concentrations of BNP were recorded before pacing and 6 months after pacing. RESULTS： Plasma concentration of BNP in VVI pacing was higher than in DDD pacing （P 〈 0.05）. Plasma concentration of BNP in high cardioventricular pacing percentage was higher than in low cardioventricular pacing percentage （P 〈 0. 05）. Plasma concentration of BNP in patients who were taking benazepril were significantly lower than in patients who did not take benazepril （ P 〈 0. 05 ）. CONCLUSION： Plasma concentration of BNP increases after pacing and increases with the cardioventricular pacing percentage. DDD pacing is superior to VVI pacing. Benazepril can delay the increase of BNP in patients with permanent cardiac pacing.