VVI及DDD起搏术对病态窦房结综合征患者血清NT-proBNP水平及左心功能的影响

The Effect of VVI and DDD Pacemaker Implantation on Serum NT-proBNP Level and Left Ventricular Function in Patients with Sick Sinus Syndrome

目的:观察右心室起搏术(VVI)及双心腔起搏术(DDD)对病窦综合征(SSS)患者血清N-末端脑钠肽前体(NT-proBNP)水平和左心功能的影响。方法:118例患者被分为VVI组(68例)和DDD组(50例)。术前及术后三个月观察比较两组患者血清NT-proBNP水平、左室射血分数(LVEF)及二尖瓣血流频谱E峰、A峰比值(E/A)的差异。结果:术后三个月,VVI组血清NT-proBNP水平由术前128.05±50.16pg/ml升至381.26±70.22pg/ml,LVEF由术前58.65±3.82%降至42.32±4.42%,E/A由术前0.98±0.23降至0.67±0.16(P均<0.05);DDD组术后三个月血清NT-proBNP、LVEF及E/A与术前比较均无统计学差异。结论:DDD起搏术对左心功能影响小,而VVI影响较大,建议选用DDD。

Objective:To observe the effect of right chamber ventricular pacemaker implantation(VVI) and dual chambers pacemaker implantation(DDD) in patients with sick sinus syndrome(SSS) on serum nterminal pro-B-type natriuretic peptide(NT-proBNP) level and left ventricular function.Method:118 patients with pacemaker implantation were divided into two groups,VVI pacing was performed in 68 patients while DDD pacing in 50 patients.Serum NT-proBNP level,left ventricular ejection fraction(LVEF) and E/A peak value of bicuspid valve blood flow spectra(E/A)were measured before and 3 months after the operation,and the difference were analyzed in statistics.Results:3 months after the operation,the NT-proBNP increased from 128.05±50.16 pg/ml to 381.26±70.22 pg/ml,LVEF decreased from 58.65±3.82% to 42.32±4.42% and B-E/A decreased from 0.98±0.23 to 0.67±0.16 in VVI group(P<0.05),but the NT-proBNP,LVEF and E/A had no statistical changes in DDD group.Conclusion:DDD pacemaker implantation has slight effect on the NT-proBNP level and LVEF compared with VVI,so it should be preferred.