摘要
目的观察心脏再同步治疗慢性心力衰竭的临床疗效。方法 36例慢性心力衰竭合并室内传导阻滞的患者行双心室再同步起搏治疗,全部患者均经冠状静脉窦植入左心室导线至心脏静脉,治疗后随访12个月,观察心功能,6 min步行距离,QRS波宽度,心室间运动延迟,左心室收缩、舒张末内径,左心室射血分数,二尖瓣反流面积。结果 31例治疗后心功能改善,有效率86.1%(31/36)。心功能从Ⅲ～Ⅳ级(纽约心脏协会心功能分级)改善为Ⅱ～Ⅲ级;6 min步行距离从(362±153)m提高至(528±165)m,差异有统计学意义(P<0.01);QRS波从(164.74±33.76)ms缩短至(129.45±42.27)ms,差异有统计学意义(P<0.01);心室间运动延迟时间从(65.19±21.50)ms缩短至(33.25±13.62)ms,差异有统计学意义(P<0.01);左心室舒张末内径从(66.52±10.23)mm缩小至(60.63±9.97)mm(P<0.05),左心室收缩末内径从(55.73±10.62)mm缩小至(47.45±11.35)mm,差异有统计学意义(P<0.01);左心室射血分数从30.35%±4.69%提高至42.27%±8.40%,差异有统计学意义(P<0.01);二尖瓣反流面积从(7.52±3.62)cm2减少至(4.33±2.07)cm2,差异有统计学意义(P<0.01)。结论心脏再同步治疗是治疗慢性心力衰竭的有效方法,能使心脏活动再同步化,改善心功能。
Objectives To observe the clinical effect of cardiac resynchronization therapy in patients with chronic heart failure. Methods Thirty-six patients with chronic heart failure and left bundle branch block received biventricular resynchronous pacing, and left ventricle leads were implanted into one of cardiac veins. During the 12-month follow-up, cardiac function, 6-minute walk distance, QRS width, inter-ventricular movement delay, left ventricular end-diastolic diameter, left ventricular ejection function and mitral regurgitation were observed. Results Heart function of 31 patients was significantly improved after the treatment and the effective rate was 86.1% （31/36）. The New York Heart Association class of the patients was improved from class III-IV to class II - III. Six-minute walk distance was increased from （362±153）m to （528±165）m （P〈0.01）. QRS width was reduced from （164.74±33.76）ms to （129.45±42.27）ms （P〈0.01 ）. Inter-ventricular movement delay was reduced from （ 65.19±21.50 ） ms to （ 33.25 ± 13.62 ） ms （P〈0.01）. Left ventricular end-diastolic diameter was decreased from （66.52±10.23）mm to （60.63±9.97）mm （P〈0.01）. Left ventricular end-systolic diameter was decreased from （55.73±10.62）mm to （47.45±11.35）mm （P〈0.01）. Left ventricular ejection fuction was increased from 30.35%±4.69% to 42.27%±8.40% （P〈0.01）. Mitral regurgitation was diminished from（7.52±3.62）cm2 to（4.33±2.07）cm2 （P〈0.01）. Conclusions Cardiac resynchronization therapy is an effective treatment for chronic heart failure.
出处
《岭南心血管病杂志》
2011年第5期380-382,共3页
South China Journal of Cardiovascular Diseases
关键词
心力衰竭
心脏再同步治疗
心脏传导阻滞
chronic heart failure
cardiac resynchronization therapy
heart conduction block
