心脏起搏对血浆脑利钠肽影响的临床研究

研究DDD与VVI起搏方式对血浆脑利钠肽 (BNP)水平的影响及其临床意义。 4 7例安装了起搏器心功能II级以上患者 ,分为DDD起搏组与VVI起搏组 ,术前测血浆BNP值及行心脏彩色多普勒超声检查 ,术后 4～ 6月内随访血浆BNP、心脏彩色多普勒超声检查。比较两组患者BNP差别、心脏射血分数 (EF)差异。结果 :DDD起搏组BNP水平较VVI组为低 (5 7.2 3± 19.19pg/mlvs 88.35± 2 3.11pg/ml,P <0 .0 5 ) ;EF值在DDD起搏组较VVI组为高 (0 .5 6± 0 .0 8vs 0 .4 5± 0 .16 ,P <0 .0 5 )。两组患者的BNP与LVEF均呈显著负性相关 (P <0 .0 5 )。结论 :DDD起搏与VVI起搏方式相比血浆BNP水平较低 ,对慢性心功能不全患者的心脏功能影响较小。

The Clinical Study About the Effect of Brain Natriuretic Peptide in Cardiac Pacing

To study and evaluate the effect of DDD and VVI pacing on the B-type natriuretic peptide (BNP) level in patients with chronic heart failure(CHF). Fourty seven pacemaker implanted patients with CHF were divided into DDD group and VVI group. BNP and left ventricular ejection fraction (LVEF) were measured before and 4 to 6 months after the operation. Results: BNP increased and LVEF decreased significantly 4 to 6 months after operation in VVI group while no significant changes were found in DDD group. Significant correlations was also found between BNP and LVEF (r = -0.76 and-0.71), in DDD group and VVI group(P<0.05). Conclusions: DDD pacing has no significant effect on the BNP level and LVEF compared with that of VVI pacing and may be of less possibility to worsen the heart function in patients with CHF. [Chinese Journal of Cardiac Pacing and Electrophysiology,2004,18(4):275～276]