核素心血池显像对58例老年人右室起搏前后左室功能评价

THE LEFT VENTRICULAR FUNCTION OF PRE AND POST VVI PACING IN AGED CAD ASSESSED BY RADIO NUCLIDE VENTRICULOGRAPHY

目的分析安装人工心脏起搏器的老年患者(无起搏器综合征)手术前后心脏血液动力学改变。方法以99mTc-RBC为示踪剂作心室造影,观察58例安装人工心脏起搏器的老年患者,女性17例、男性41例,年龄65～90岁,平均70.61±6.27,于手术前1周、术后2周分别进行核素心血池显像,观察心功能参数,包括收缩功能参数:左室射血分数(LVEF)、高峰射血率(PER)、高峰射血时间(TPER)、前1/3射血分数(1/3EF)。舒张功能参数:高峰充盈率(PFR)、高峰充盈时间(TPFR)、前1/3充盈分数(1/3FF)。结果与术前相比,显示术后LVEF、PER和1/3EF等有改善(P<0.001;P<0.05)。结论老年冠心病、原发性传导束退化症等Ⅱ度Ⅱ型及Ⅲ度AVB伴症状性心动过缓患者在接受VVI人工心脏起搏术后(不伴有起搏器综合征),左室收缩功能可得到改善,但对心室舒张功能无明显帮助,因此VVI起搏对此类病人的血液动力学的影响还是部分有益的。

Objective To analyse the hemadynamic changes p re and after operation with the radio nuclide ventriculog-raphy in the aged patients who implan ted the permanent pacemakers(without pacemaker syndrome ).Methods 58cases im-planted the permanent pacemakers(17females ,41males ,aged 65～90year-old,average 70.61±6.27)were investigated with radio nuclide ventriculography in 1week before and 2weeks after operation.The left ventricular functi on was determined,including systolic function parame ters such as left ventricular ejection frection(LVEF),peak ejection rate(PER),peak ejection rate time (TPER),1/3ejection fraction(1/3EF)and diastolic function parameters:peak filling rate(PFR),peak filling rate time (TPFR),1/3filling fraction(1/3FF).Results Compared with pre operation ,LVEF ,P ER and 1/3EF had im-provement after operation.The differences between pre and post operation were significant (P<0.001).Conclusions Left ventricular function in elderly patients with coronary heart disease or primary conduct bundle degeneratio n(typeⅡsecond degree and third degree AV block with sympto matic bradycardia)is improved after implanting perman ent pacemakers without pacemaker syndrome,therefore VVI type some of is beneficial to the hemadynamics of this kind of patients.[