生理性与非生理性起搏13年随访对比观察

目的比较生理性与非生理性心脏起搏（ＶＶＩ）的远期效果。方法通过对１９８５年至１９９８年１３年内临床应用的生理性起搏１６２例和非生理性起搏５３８例进行回顾性分析。结果生理性起搏组明显优于非生理性起搏组，其百分率分别为，心影缩小为１５．４％（２５／１６２）ｖｓ０．１８％（１／５３８）；心影扩大３．０％（５／１６２）ｖｓ２７．７％（１４９／５３８）；心功能改善７．４％（１２／１６２）ｖｓ０．４％（２／５３８）；心功能恶化１．２％（２／１６２）ｖｓ１６．３５％（８８／５３８）；房性心律失常减少１３．５％（２２／１６２）ｖｓ０．２％（１／５３８）；房性心律失常增加０．６％（１／１６２）ｖｓ７．６％（４１／５３８）；脑栓塞１．２％（２／１６２）ｖｓ３．３％（１８／５３８）；死亡率１．２％（２／１６２）ｖｓ７．６％（４１／５３８）；唯电极脱位则为７．４％（１２／１６２）ｖｓ２．２％（１２／５３８）（Ｐ＜０．０５）结论生理性起搏在消除症状、提高生活质量，改善心功能，防止室上性心律失常方面优于非生理性起搏。

Comparative investigation of physiologic and nonphysiologic pacing in thirty years foolowup period

Objective Comparative investigation of physiologic and non physiologic pacing in 13 years foolowup period. Mothod Retrospectively analysed 162 patients(pts)of physiologic pacing with AAI (74 pts),AAIR(1pt),DDD(58pts),DVI(8pts),DDDR(6pts),VDD(4pts),VVIR(11pts),and 538 patients with nonphysiologic VVI pacing in the period of 19851998. Results Physiologic pacing is better than nonphysiologic pacing (P<0.05),the present rate are as following respectively:smaller of cardiac image 15.4% vs 0.18%,enlargement of cardiac image 3.0% vs 27.7%;improving of cardiac function 7.4% vs 0.4%;worse of cardiac function 1.2% vs 1635%,incidence decrease of atrial arrhythmias 13.5% vs 0.2% incidence increase of atrial arrhythmias 0.6% vs 7.6% cerebral embolism 1.2% vs 3.3%;mortality 1.2% vs 7.6%,but leads dislocation of physiologic pacing vs nonphysiologic pacing are 7.4% vs 2.2%,respectively. Conclusion Physiologic pacing are much better than nonphysiologic pacing in improving living quality and heart function as well as preventing atrial arrhythmias and cerebral embolism.