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右室流入道间隔部和心尖部起搏的临床疗效对比 被引量:1

Clinical Comparative Study of Right Ventricular Inflow Tract Septal Pacing and Right Ventricular Apical Pacing
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摘要 目的探讨右室流入道间隔部(RVIS)和右室心尖部(RVA)起搏,治疗缓慢性心律失常神经内分泌激素和心功能的变化。方法 106例行DDD起搏器治疗的患者:男86例,女20例,年龄45~86岁,平均76岁,随机分为:右室流入道间隔部起搏组(RVIS起搏组)56例,右室心尖部起搏组(RVA起搏组)50例。2组心房电极均植入右心耳梳状肌内,RVIS起搏组心室电极植入右室流入道间隔部、RVA起搏组心室电极植入右室心尖部。分别观察2组在起搏器植入时、起搏3个月和6个月不同时期,血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、心钠肽(BNP)和去甲肾上腺素(NE)等神经内分泌激素的含量;用彩色多普勒超声心动图测定:心排血量(CO)、每搏输出量(SV)、射血分数(EF)、左室舒张末内径(LVDd)和左室短轴缩短分数(FS)。结果 RVA起搏组治疗后其神经内分泌激素和心功能,较起搏治疗前恶化,且随着起搏时间的延长趋于明显,而RVIS起搏组,其神经内分泌激素和心功能改变,较起搏治疗前明显改善,且随着起搏时间的延长改善的越明显,与RVA起搏组比较,具有统计学意义(P<0.05)。结论 RVIS起搏优于RVA起搏,可明显改善心功能,纠正神经内分泌激素失调,值得临床推广。 Objective To investigate the changes of neuroendocrine hormone and cardiac function in arrhythmia patients when treated by right ventricular inlet septal(RVIS) pacing or right ventricular apex(RVA) pacing. Methods A total of 106 patients treated with DDD pacemaker:86 cases of male and 20 female,aged 45~86 years,mean 76 years,were randomly divided into two groups:the right ventricular inlet septal pacing group(RVIS pacing group) 56 cases,right ventricular apical pacing(RVA pacing group) 50 cases.In the two groups,the atrial electrode were implanted in the right atrial appendage comb muscles,RVIS ventricular pacing electrodes implanted at right ventricular inlet septal,RVA pacing ventricular leads implanted in right ventricular apex.The two groups were observed in the pacemaker implantation,the pacing for 3 months and 6 months,measured the plasma renin activity(PRA),angiotensin Ⅱ(Ang Ⅱ),aldosterone(ALD),cardiac natriuretic peptide(BNP) and norepinephrine(NE) and other neuroendocrine hormone levels;use color Doppler echocardiography:cardiac output(CO),stroke volume(SV),ejection fraction(EF),left chamber end diastolic diameter(LVDd) and left ventricular fractional shortening fraction(FS). Results In RVA pacing group,the neuroendocrine hormones and their heart function deteriorated compared with before pacing,and became more obvious with the time went on,but in RVIS pacing group,the neuroendocrine hormone and cardiac function significantly improved,compared before pacing,and with the time pacing the more obvious improvement.Compared with RVA pacing,there were significant difference(P0.05) in RVIS group. Conclusion Compared with RVA pacing,RVIS pacing can significantly improve cardiac function,correct the imbalances of neuroendocrine hormones,it is worthy of promotion.
出处 《医药论坛杂志》 2010年第24期17-20,共4页 Journal of Medical Forum
关键词 RVIS RVA 起搏 神经内分泌激素 心功能 RVIS RVA Pacing Neuroendocrine hormone Cardiac function
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参考文献8

  • 1Parekh S, Stein KM. Selective site pacing rationale and practical application [J]. Curr Cardiol Rep, 2008,10 (5) :351.
  • 2张贵生,荣蓉,张婷婷,马锋,李隆贵.右心室流入道起搏治疗缓慢性心律失常44例临床观察[J].心肺血管病杂志,2008,27(4):231-232. 被引量:7
  • 3Nohria A, Mie Iniczuk LM, Stevenson LM. Evaluation and monitoring of p patients with acute heart failure syndromes[J]. Am J Cardiol,2005,96(6A) :32G-40G.
  • 4Connolly SJ, Kerr CR, Gent M, et al. Effects of physiologic pacingversus ventricular pacing on the risk of stroke and death due to cardiovascular causes. Canadian Trial of Physiologic Pacing Invertigators[J].N Engl J Med, 2000, 342:1385-1391.
  • 5周宁,陈曼华,罗洪波,王琳.右心室心尖部起搏和右心室间隔部起搏对起搏参数和心电图的影响[J].心脏杂志,2008,20(1):80-82. 被引量:12
  • 6Hillock RL, Stevenson IH, Mond HG. The right ventricular outflow tract a Comparative study of sepatl anterior wall ahd free wall pacing [ J ]. Pacing Clin Electrophysiol, 2007, 30(8): 942.
  • 7Manohar P, Pina IL. Therapeutic role of angiotensin II receptor biockers in The treatment of heart failure [ J ]. Mayo Clin Proc, 2003, 78:334-338.
  • 8Barents M, Hillege HH, van der Horst IC, et al. BNP and NT - pro BNP, predictors of 1 - year mortality in nursing home residents [ J]. J Am Med Dir Assoc, 2008, 9(8) :580-585.

二级参考文献17

  • 1张清,王海昌,刘兵,李伟杰,程何祥,李成祥,李媛,王小燕.双心室起搏治疗慢性心力衰竭伴心室内传导阻滞患者的近期疗效[J].心脏杂志,2006,18(2):214-215. 被引量:2
  • 2陈新 孙瑞龙 等.临床心电生理学和心脏起搏[M].北京:人民卫生出版社,1999.574-577.
  • 3karpawich PP, Mital S. Comparative left ventricular function following atrial, septal, and apical single chamber heart pacing in the young[ J ]. Pacing Clin Electrophysiol, 1997, 20(8 Pt 1 ) : 1983 - 1988.
  • 4Chwab B, kindermann M, frohlig G, et al. Septal lead implantation for the reduction of paced QRS duration using passive fixation leads [J]. Pacing Clin Electrophysiol, 2001,24(12) :28 -33.
  • 5Dreifus LS,Fisch C,Griffin JC,et al. Guidelines for implantation of cardiac pacemakers and antiarrhythmia devices. A report of the American college of cardiology/american heart association task force on assessment of diagnostic and therapeutic cardiovascular procedures ( Subcommittee on pacemaker implantation) [ J ]. J Am Coll Cardiol, 1991, 18( 1 ) : 1 - 13.
  • 6Scherlag B J, Kosowsky B, Damato A. A technique for ventricularpacing from the His bundle of the intact heart [ J ]. J Appl Physiol, 1967, 22(3) :584 -587.
  • 7Karpawieh P, Gates J, Stokes K. Septal His-Purkinje ventrieular pacing in canines: a new endecardial electrode approach [ J ]. Pacing Clin Electrophysiol, 1992, 15( 11 ) :2011 -2015.
  • 8Liebennan R, Grenz D, Mond HG, et al. Selective site pacing: defining and reaching the selected site[ J ]. Pacing Clin Electrophysiol ,2004, 27(6 Pt2): 883-886.
  • 9Scheinman MM, Saxon LA. Long-term His-bundle pacing and cardiac function [ J ]. Circulation, 2000,101 (8) : 836 - 837.
  • 10Lamas GA, Lee KL, Sweeney M, et al. Ventricular pacing or dual-chamber pacing for sinus-node dysfunction. N Engl J Med, 2002, 346: 1854-1862.

共引文献15

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  • 1郭自强,王硕仁,朱陵群,牛福玲,黄启福.益气活血中药对血管紧张素Ⅱ致培养乳鼠心脏间质成纤维细胞增殖的影响[J].中西医结合心脑血管病杂志,2005,3(7):605-607. 被引量:6
  • 2Afridi I, Kleiman NS, Raizner AE, et al. Dobutamine echocardiography in myocardial hibernation. Optimal dose and accuracy in predicting recovery of ventricular function after coronary angioplasty [ J ]. Circulation, 1995,91 ( 3 ) :663 670.
  • 3Ganau A, Devereux RB, Picketing TG, et al. Relation of leftventricular hemodynamic load and contractile performance to leftventricularmass in hypertension [ J ]. Circulation, 1990, 81 (1) :25 -36.
  • 4Kang PM, Izumo S. Apoptosis in heart:basic mechanisms and implications in cardiovascular diseases [ J ]. Trends Mol Med, 2003,9(4) :177 -182.
  • 5Peterson T, Li H, Dillon L, et al. Evolution of matrix metalloprotease and tissue inhibitor expression during heart failure progression in the infarcted rat [ J ]. Cardiovasc Res,2000,46 (2) :307 -315.
  • 6Li YY, Feng YQ, Kadokami T, et al. Myocardial extracellularmatrix remodeling in transgenicmice overexpressing tumornecrosis factor alphacanbe modulated by anti tumor necrosis factor alpha theraphy [ J ]. Proc Natl Acad Sci USA, 2000,97 (23) : 12746 12751.
  • 7Wisenbaugh T. Does normal pump function belie muscle dysfimction in patients with chronic severe mitral regurgitition [ J]. Circulation, 1988,77 (3) :515 525.
  • 8Mirsky I, Corin W J, Murakami T, et al. Correction for preload in assessment of myocardial contractility in aortic and mitral valve disease. Application of the concept of systolic myocardial stiffness[ J ]. Circulation, 1988,78 ( 1 ) :68 80.
  • 9无.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095. 被引量:3696
  • 10王小霞,杨积武.杨积武教授强心宁煎剂联合西药治疗慢性心衰临床经验[J].辽宁中医药大学学报,2009,11(9):74-75. 被引量:5

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