不同起搏方式对患者左心结构与功能及NT-proBNP的影响

【目的】探究生理性起搏（DDD）和非生理性起搏（VVI）对心脏结构及 N-末端脑钠肽前体（NT-proBNP）的影响，并为起搏器植入心脏后的应对策略积累经验。【方法】选取本院心内科于2012年1～12月收治的65例接受起搏器治疗患者，根据不同起搏方式进行分组。其中对照组患者采取 VVI，研究组采取DDD，比较两组患者在植入起搏器前后左心室结构和功能及 NT-proBNP水平变化。【结果】两组患者在植入起搏器前的左心房内径（LAD）、左心室舒张末期内径（LVD）、室间隔厚度（IVST）、左心室后壁厚度（PWT）、左心室射血分数（EF）方面差异无统计学意义（P ＞0．05）；植入起搏器后，研究组 LAD小于对照组（P ＜0．05），EF高于对照组（P ＜0．05）。两组患者在起搏器植入前 NT-proBNP 值差异无统计学意义（P ＞0．05）；安置起搏器后，研究组 NT-proBNP值低于对照组（P ＜0．05）。【结论】有起搏器植入适应证的患者，为减少起搏对心脏结构和功能的影响，应当选择房室顺序起搏为宜。

Influence of Different Pacing Modes on Left Heart Function and NT-proBNP

Objective]To explore the influence of physiological pacing（DDD）and non-physiological pa-cing（VVI）on cardiac structure and N-terminal pro-brain nitric peptide（NT-proBNP）in order to accumulate the experience for the coping strategies after cardiac pacemaker implantation.Methods]A total of 6 5 patients treated with pacemaker in cardiology department of our hospital from Jan.2012 to Dec.2012 were chosen. According to different pacing mode,all patients were divided into two groups.The control group was treated with VVI,while the study group was treated with DDD.Left ventricular structure and NT-proBNP in two groups before and after pacemaker implantation were recorded and compared.Results]There was no signifi-cant difference in LAD,LVD,IVST,PWT and EF before pacemaker implantation between two groups（P〉0.05）.After pacemaker implantation,LAD in the study group was lower than that in the control group（P〈0.05）,while EF in the study group was higher than that in the control group（P〈0.05）.There was no sig-nificant difference in NT-proBNP before pacemaker implantation between two groups（P〉0.05）.After pace-maker implantation,NT-proBNP in the study group was lower than that in the control group （P 〈0.05）.Conclusion]Patients with the indications of pacemaker should be treated with atrial-ventricular sequential pa-cing in order to reduce the effect of pacing on cardiac structure and function.