双心室再同步治疗对慢性心力衰竭患者的近期疗效观察

目的观察心脏再同步治疗（cardiac resynchronization therapy，CRT）对慢性心力衰竭（congestive heart failure，CHF）患者的近期疗效。方法入选心功能Ⅲ级。Ⅳ级CHF患者30例，分为CRT组15例，对照组15例。两组于治疗前、治疗后1个月及3个月分别评估心功能．测定6min步行距离。Minnesota生活质量问卷评估（QOF），超声心动图测量左室射血分数（LVEF）、左心室舒张末期内径（LVEDD），观察两组的死亡率和再住院率。结果治疗后1个月、3个月，CRT组NYHA心功能分级、6min步行距离、QOF、LVEF及LVEDD均较治疗前改善（治疗前分别为3．38±0．53、218．61±79．02m、42．68±18．82、0．30±0．05、71．52±6．10mm，治疗3个月分别为1．91±0．72、427．62±25．46m、20．33±15．57、0．38±0．08、66．85±5．59mm），差异有统计学意义（P〈0．05．P〈0．01）；与对照组（治疗3个月时分别为3．30±0．63、242．71±62．52m、42．75±27．32、0．32±0．07、71．88±6．49mm）比较．差异有统计学意义（P〈0．05，P〈0．01），CRT组再住院率低。结论CRT有助于纠正CHF患者的血流动力学紊乱，使扩大的心腔缩小．改善患者的心功能．提高其生活质量。

The short-term effects of cardiac resynchronization therapy in patients with congestive heart failure

Objective The aim of this study was to observe the short-term effect of CRT in patients with congestive heart failure. Methods Thirty patients with New York Heart Association （NYHA）class I1 to IV,were divided into 2 groups, 15 patients received biventricular pacing therapy and the other 15 patients received the same optimal medical therapy （control group）. Investigations including 6-minute hall-walking test （6MWT）,Minnesota Living with Heart Failure questionnaire for quality-of-life assessment, echocardiography （to survey LVEDD, LVEF）were performed at baseline and 1 months, 3 months respectively after C RT or optimal medical therapy alone. Meanwhile,the mortality and rehospitalization rate of the two groups were observed. Results At 1 month and 3 month follow-up,NYHA class,6 MWT,the quality-of-life scores,LVEF and LVEDD were improved in CRT group compared with baseline values（the baseline value was 3.38±0.53,218.61±79.02 m,42.68±18.82,0.30±0.05,71.52±6.10 mm respectively and after 3 months,therapy group was 1.91±0.72,427.62±25.46 m,20.33±15.57,0.38±0.08,66.85±5.59 mm respectively）,P〈 0.05-0.01 ;and compared with that in control group （that was 3.30±0.63,242.71±62.52 m,42.75±27.32,0.32±0.07,71.88±6.49 mm respectively after 3 months,therapy）,P〈0.05-0.01 ,and rehospitalization rate was reduced in CRT group. Conclusions CRT helps to correct hemodynamic disturbance,enhances quality of life and heart function,reverses LV remodeling.