糖尿病对永久人工心脏起搏器术起搏参数及并发症的影响

目的：观察糖尿病对植入永久人工心脏起搏器患者起搏参数及术后并发症的影响。方法：2008年6月～2011年6月80例植入永久人工心脏起搏器的病窦综合征患者，按是否有糖尿病分为糖尿病组（40例）和非糖尿病对照组（40例）。比较两组起搏器起搏参数及术后并发症。结果：基线时两组患者起搏器心房、心室起搏阈值，感知，阻抗差异均无显著性（P＞0.05）。术后12月两组起搏器各参数均有不同程度增高；与非糖尿病组相比，糖尿病组心房、心室起搏阈值[心房：（0.59±0.23）V比（0.67±0.25）V，心室：（0.47±0.28）V比（0.54±0.35） V]、感知[心房：（2.33±1.16）mV比（2.92±1.36）mV，心室：（12.21±4.82）mV比（12.77±5.36）mV]、阻抗[心房：（537.12±115.32）Ω比（662.48±235.26）Ω，心室：（602.48±222.46）Ω比（762.41±235.38）Ω]增高更为明显（P＜0.05或＜0.01）；术后并发症发生率糖尿病组明显高于非糖尿病组（12.5％比5％）。结论：合并糖尿病的病窦综合征心电重构较严重，植入永久人工心脏起搏器后并发症发生率明显升高。

Impact of diabetes mellitus on pacing parameters and complications in patients with implantation of ;permanent artificial cardiac pacemaker

Objective：To observe the impact of diabetes mellitus （DM）on pacing parameters and postoperative com-plications in patients With implantation of permanent artificial cardiac pacemaker.Methods：A total of 80 patients With sick sinus syndrome,Who received implantation of permanent artificial cardiac pacemaker from Jun 2008 to Jun 2011,Were enrolled.According to complicated With DM or not,they Were divided into DM group （n=40）and non-DM control group （n=40）.Pacing parameters and postoperative complications Were compared betWeen tWo groups.Results：There Were no significant difference in atrial and ventricular pacing threshold,sensing and of pace-maker impedance in baseline betWeen tWo groups （P〉0.05）.All parameters of pacemaker increased in tWo groups after implantation 12 months;compared With non-DM control group,there Were significant increase in pacing threshold [atrial：（0.59±0.23）V vs.（0.67±0.25）V,ventricular：（0.47±0.28）V vs.（0.54±0.35）V],sens-ing [atrial：（2.33±1.16）mV vs.（2.92±1.36）mV,ventricular：（12.21±4.82）mV vs.（12.77±5.36）mV], impedance [atrial：（537.12±115.32）Ωvs.（662.48±235.26）Ω,ventricular：（602.48±222.46）Ωvs.（762.41± 235.38）Ω]of pacemaker in DM group,P〈0.05 or 〈0.01;and incidence rate of postoperative complications （12.5%）in DM group Was significantly higher than that of non-DM control group （5%）,P〈0.05.Conclusion：Electrocardiographic reconstruction is more severe in SSS patients complicated DM,in these patients postoperative complication incidence significantly elevates.