心脏再同步化治疗慢性心力衰竭的疗效观察

目的观察心脏再同步化治疗(CRT)慢性心力衰竭(CHF)的临床疗效。方法26例CHF患者行CRT,全部患者均经冠状静脉窦置入左室导线1根至心脏静脉,术后随访13.8±10.4个月,观察心功能,患者活动度及夜间心率、QRS波时限,左室射血分数(LVEF)及相关心功能超声指标。结果24例治疗后心功能改善,2例猝死,有效率92.3%,心功能NYHA分级,从Ⅲ～Ⅳ级改善为Ⅱ～Ⅲ级,患者活动度从0.17±0.24小时/天增加至2.98±0.46小时/天,夜间心率由80.8±12.0次/分降低至61.3±2.5次/分,QRS波时限从158.60±31.86ms缩短至130.95±23.44ms,P<0.05。LVEF从0.21±0.05提高至0.35±0.05,P<0.05,其他相关超声指标较CRT之前明显改善(P均<0.05)。结论CRT是治疗CHF的有效方法。

Clinical observation of resynchronization therapy for patients with chronic heart failure

Objective To observe the clinical effect of cardiac resynchronization therapy (CRT) in patients with chronic heart failure(CHF). Methods Twenty-six patients with CHF received CRT,and left ventricle leads were implanted into one of cardiac veins.After 13.8±10.4 months follow-up, the heart function, patient activity, QRS width, left ventricular ejection fraction (LVEF) and other ultrasound indexes were observed. Results The heart function of 24 patients was significantly improved after the treatment and 2 cases died.The NYHA class of the patients improved from class Ⅲ～IV to class Ⅱ～Ⅲ.The patient activity increased from 0.17±0.24 hours/day to 2.98±0.46 hours/day,night ventricular rate decreased from 80.8±12.0 bpm to 61.3±2.5 bpm. The QRS width reduced from 158.60±31.86 ms to 130.95±23.44 ms,P<0.05. LVEF increased from 0.21±0.05 to 0.35±0.05,P<0.05. Other ultrasound indexes had all significantly increased compared with pre-CRT, P<0.05. Conclusions CRT is an effective treatment for CHF.