不同起搏模式对老年人血浆内皮素1和一氧化氮水平的影响

目的观察老年患者置入具有工作模式转换功能的双腔起搏器术后心室起搏百分比与血浆内皮素1及NO水平的关系。方法入选置入双腔起搏器的老年患者24例,分为A组12例和D组12例。采用自身前后交叉对照研究方法,观察同一患者在心房按需型起搏(AAI)SafeR和房室全能型起搏(DDD)工作模式下的心室起搏百分比,检测患者内皮素1及NO水平并分析两者的关系。结果与术前比较,A组和D组术后3、6个月内皮素1及NO水平明显升高;与术后3个月比较,A组和D组术后6个月内皮素1水平明显升高(1.02±0.21)μg/L vs(0.98±1.00)μg/L,(2.35±0.96)μg/L vs(2.31±1.07)μg/L,P<0.05]。与DDD模式比较,AAISafeR模式时心室感知百分比明显升高,心室起搏百分比明显降低(P<0.01)。相关分析显示,心室起搏百分比与内皮素1及NO水平呈正相关(r=0.125,P<0.01)。结论 AAISafeR模式可有效减少心室起搏百分比,心室起搏可能产生起搏依赖性的心功能损害。

Effect of different pacing modes on plasma ET-1 and NO level in elderly patients

Objective To study the relation of cumulative percent of ventricular pacing(Cum%VP) with plasma ET-1and NO level in elderly patients after double-chamber pacemaker implantation. Methods Twenty-four patients after double-chamber pacemaker implantation were divided into group A and group B(12in each group).Their Cum%VP in AAISafeR and DDD pacing modes was observed and their plasma ET-1and NO levels were measured.Relation of Cum%VP with plasma ET-1and NO level was analyzed.Results The plasma ET-1and NO levels were significantly higher in two groups 3and 6months after operation than before operation(P<0.05).The plasma ET-1level was significantly higher in two groups 6months after operation than 3months after operation(P<0.05).The Cum%VP was significantly higher in AAISafeR pacing mode than in DDD pacing mode(P<0.01).Correlation analysis showed that the Cum%VP was positively related with the plasma ET-1and NO level(r=0.125,P<0.01).Conclusion The AAISafeR pacing mode can effectively reduce the Cum%VP and ventricular pacing may damage the heart function in a pacing-dependent manner.