双腔起搏对血浆脑钠肽值的影响

目的 探讨双腔起搏器心室起搏比例与血浆脑钠肽值的关系。方法52例双腔起搏器植入患者分别在术后和房室延迟调整后第3个月末程控测取心室起搏比例及血浆脑钠肽值，并按心室起搏比例分成≥40％组（35例）和〈40％组（17例）。结果术后心室起搏比例≥40％组和〈40％组的血浆脑钠肽对数值分别为2．06±0.26和1．77±0．28，差异有非常显著性意义（P〈0．01）。心室起搏比例≥40％组经过房室延迟调整后心室起搏比例从（65．0±12．3）％下降为（44．1±7．3）％，血浆脑钠肽对数值从2．06±0．26下降为1．79±0．31，差异有非常显著性意义（P〈0．01）。结论减少双腔起搏器的非必需心室起搏，可减少对心功能及血流动力学的不利影响。

Effects of Dual-Chamber Pacing on Plasma B-Type Natriuretic Peptide Level

Objective To assess the relationship between cumulative percent ventricular paced（Cum%Vp） and plasma B-type natriuretic peptide （BNP） level in patients with dual-chamber pacemakers. Methods Cum%Vp and logarithmic value of plasma BNP were measured in 52 patients at three months after implantation of pacemakers and adjustment of atrioventricular delay, respectively. Results Logarithmic value of plasma BNP was significantly higher in patients with Cum%Vp ≥40%（ 2.06 ± 0.26 ） than with Cum%Vp〈40% （ 1.77± 0.28 ） （ P 〈 0.01 ）. As Cum%Vp decreased from （ 65.0 ±12.3）% to （44.1±7.3 ）% after adjustment of atrioventrioular delay in patients with Cum%Vp ≥40%, the logarithmic value of plasma BNP decreased significantly from 2.06 ±0.26 to 1.79 ± 0.31 （ P 〈 0.01 ）. Conclusion Decreasing unnecessary ventricular pacing of dual-chamber pacing may reduce its adverse effect on cardiac function and hemodynamics.