心脏起搏器综合征患者心室失同步化和收缩功能的变化研究

目的探讨心脏起搏器综合征患者心室失同步化和收缩功能的变化的临床意义。方法2010年5月～2012年5月我院因慢室率心房颤动（房颤）而安置VV]型起搏器的患者152例中，产生PMS患者19例（PMS组），其他133例未产生PMS的患者中，随机选取20例患者（无PMS组），另选取20例房颤未安置起搏器的患者作为对照组。所有患者均用组织多普勒影像技术测定左、右心室侧壁和室间隔的收缩峰值速度（Vs）、加速度（As）和达峰时（Ts）。结果PMS组与无PMS组左、右心室侧壁的Vs、As与对照组比较，差异有统计学意义（P〈0．05）；PMS组与无PMS组之间h、As比较，差异无统计学意义（P〉0．05）；三组Vs、As比较室问隔收缩比较，差异无统计学意义（P〉0．05）。PMS组与无PMS组左、右心室侧壁与室间隔Ts较对照组显著延长（P〈0．05）；PMS组与无PMS比较，左室侧壁与室间隔Ts比较差异无统计学意义（P〉0．05），而右室侧壁与室间隔Ts比，差异有统计学意义（P〈0．05）。结论右室失同步化是PMS中的一个重要因素，而心室收缩功能的变化和左室失同步化并不重要。

The changes of patients with ventricular asynchrony and systolic function of cardiac pacemaker

Objective To observe the changes of patients with ventricular asynchrony and systolic function of cardiac pacemaker. Methods 152 cases and placement of VVI pacemaker patients from May 2010 to May 2012 in my courtyard were collected with slow ventricular rate in atrial fibrillation（AF）, 19 cases of PMS patients were collected as PMS group, among the other 133 cases without PMS patients, 20 patients were randomly selected as non PMS group, the other 20 cases of real fibrillation without pacemaker patients were collected as ascontrol group. All patients were treated with peak systolic velocity of left, right ventricular lateral wall and interventricular septum were measured by tissue Doppler imaging （Vs）, acceleration （As） and time t~~ peak （Ts）. Results The Vs, As of PMS group and non PMS group of left, right ventricular lateral wall of compared with the control group, the difference was statistically significant （P 〈 0.05）, Vs, As of PMS group and non PMS group compared, there was no significant difference （P 〉 0.05）; three groups of Vs, As septal systolic, there was no significant difference （P 〉 0.05）. PMS group and non PMS group of left, right ventricnlar wall and interventricular septal Ts were significantly longer than those of control gronp（P 〈 0.05）; PMS group and non PMS comparison, left ventricular lateral wall and septal Ts not significant difference（P 〉 0.05）, and right ventricular wall and interventricular septum（Ts ratio, significant difference（P 〈 0.05）. Conclusion Right ventricular asynchrony is an important factor in PMS, and the changes of cardiac function and left ventricular asynchrony is not important.