心脏再同步化治疗扩张性心肌病心力衰竭疗效观察

目的探讨心脏再同步化治疗（CRT）扩张性心肌病心力衰竭的效果。方法选择72例内科药物治疗（治疗时间兰1月）不理想的扩张性心肌病心衰患者，超声心动图、心电图检查证实存在明显的室间、伴／不伴室内机械性不同步。将入选患者随机分成两组：Ⅰ组，40例，继续药物治疗；Ⅱ组（CRT组），32例，植入心脏三腔起搏器行再同步化治疗，并于术后1个月、6个月时根据超声检查调整优化起搏参数。观察比较两组患者6个月后治疗效果。结果CRT组患者术后6个月心脏的同步性、左室射血分数（LVEF）、左室舒张末内径（LVDd）、左室舒张末容积（EDV）、左室收缩末容积（ESV）明显优于药物治疗组（P〈O．01）。结论CRT治疗可改善难治性扩张性心肌病心衰患者预后。

Objective To explore the effect of cardiac resynchronization therapy（CRT） on congestive heart failure（CHF） in the patients with dialated cardiomyopathy（DCM）. Methods 72 patients were involved.They have been teated with medicine for 1 month at least,bnt can＇t be better any more. Desynchronization exsisted in two ventriculars or among left ventricular by detecting echocardiography and electrocardiogrom.The patients were divided into two groups.Patients in one group continued taking medicine,patients in other group accepted CRT.6 months later the effect was compared. Results The index such as LVEF,LVDd,EDV, ESV and the synchronization ofventriculars were all better in the group of CRT（P〈0.01）. Conclusion The outcome of CHF in the patients with DCM can be improved significantly.