不同右室起搏比率对长R-R间期房颤合并心衰患者血浆脑钠肽的观察

An observation of clinical effects of different right ventricular pacing percentages on plasma brain natriuretic peptide in patients with atrial fibrillation in long R-R interval complicated with heart failure

目的探讨不同右室起搏比率对长R—R间期房颤合并心衰患者血浆脑钠肽的临床效果。方法选取2010年1月-2011年12月在我院进行治疗46例的R—R间期房颤的患者，左室功能正常者分对照组，左室功能不正常者为治疗组，比较患者治疗前后右室起搏比率、LAD、LVEF以及血浆NT-proBNP。结果治疗组患者治疗1年之后LAD值为（35．10±1．78）mm，明显高于对照组的（39．24±2．14）mm，两组相比具有显著性差异（P〈0．05）；治疗组患者的LVEF为（57.3±3．6）％，明显低于对照组的（64．1±4．8）％，两组相比具有显著性差异（P〈0．05）；治疗组患者的血浆NT-proBNP值为（345．1±11．6）pg／mL，明显高于对照组的（78．2±9．8）pg／mL，两组相比具有显著性差异（P〈0．05）。结论对长R—R间期房颤合并心衰患者进行不同的右室起搏比率，治疗后，取得了较好的临床效果，LAD明显增大，LVEF明显降低，而血浆NT—proBNP明显升高，值得在临床上推广使用。

Objective To explore the clinical effects of different right ventricular pacing percentages on plasma brain natriuretic peptide in patients with atrial fibrillation in long R-R interval complicated with heart failure. Methods 46 patients with atrial fibrillation in R-R interval who were treated in our hospital from January 2010 to December 2011 were selected.Those with normal left ventricular function were assigned to a control group,while those with abnormal left ventricular function were assigned to a treatment group. Right ventricular pacing percentages,LAD,LVEF and plasma NT-proBNP in patients before and after the treatment were compared. Results After 1 year of the treatment,LAD value in the treatment group was（35.10 ± 1.78）mm, significantly higher than that of （39.24 ± 2.14）mm in the control group,and the difference was statistically significant（P 〈 0.05）;LVEF in the treatment group was（57.3 ± 3.6）%,significantly lower than that of （64.1 ± 4.8）% in the control group,and the difference was statistically significant（P 〈 0.05）;plasma NT-proBNP value in the treatment group was （345.1 ± 11.6） pg/mL,significantly higher than that of（78.2 ± 9.8）pg/mL in the control group,and the difference was statistically significant（P 〈 0.05）. Conclusion Different right ventricular pacing percentages for patients with atrial fibrillation in long R-R interval complicated with heart failure have a favorable clinical effect,showing that LAD significantly increased, LVEF significantly lowered, and plasma NT-proBNP significantly increased.The treatment is therefore worthy of clinical promotion and application.