摘要
目的研究临时心脏起搏器植入术(TPI)对Ⅲ度房室传导阻滞(Ⅲ-DAB)患者的心功能及血浆脑钠肽(BNP)、血清心肌肌钙蛋白(cTnI)等指标的影响。方法选择2010年5月至2016年5月在我院心内科接受TPI术式治疗的88例Ⅲ-DAB患者作为观察组,另选同期在医院进行健康体检的志愿者85例作为对照组,统计两组受检者的血浆BNP、血清cTnI,以及观察组TPI治疗前后的心功能指标,分析观察组各指标间的相关性及患者预后。结果观察组患者的BNP(112.24±17.33)pg/mL及cTnI水平(1.28±0.26)ng/mL均明显高于对照组的(28.53±9.82)pg/mL及(0.03±0.02)ng/mL,差异有统计学意义(P<0.05);观察组患者TPI治疗后的左室射血分数(LVEF)(69.27±6.33)%及心脏指数(CI)(4.18±0.13)L/min·m^2,均明显高于TPI治疗前的(51.39±3.17)%及(3.15±0.11)L/min·m^2,左房内径(LAD)(31.19±3.06)mm及左室舒张末期内径(LVEDD)(42.18±4.13)mm均明显低于TPI治疗前的(43.58±5.21)mm及(50.26±5.30)mm,差异有统计学意义(P<0.05);观察组患者经TPI治疗后的BNP(41.83±9.87)pg/mL及cTnI水平(0.53±0.07)ng/mL均明显低于TPI治疗前的(112.24±17.33)pg/mL及(1.28±0.26)ng/mL,差异有统计学意义(P<0.05);根据Spearman法分析相关性可知,观察组患者的血浆BNP和血清cTnI均分别与LVEF及CI呈负相关(r=-5.394、-7.108、-6.024、-6.138),与LAD及LVEDD呈正相关(r=6.133、5.971、5.421、5.620);观察组患者均经TPI治疗后一次植入成功,成功率为100%,治疗后并未出现明显的并发症。结论利用TPI术式治疗Ⅲ-DAB患者具有较好的疗效及安全性,且患者的血浆BNP和血清c Tn I与LVEF及CI呈负相关,与LAD及LVEDD呈正相关,值得临床重视。
Objective To study influence of temporary pacemaker implantation（TPI） on cardiac function,BNP,cTnI and other indexes in the treatment of patients with Ⅲ degree atrioventricular block（Ⅲ-DAB）.Methods From May 2010 to May 2016,88 patients with Ⅲ-DAB were enrolled in the study with TPI for treatment.At the same period,85 cases healthy volunteers in the hospital were selected as the control group.The plasma B-type natriuretic peptide（BNP） and serum cardiac troponin-I（cTnI） of the two groups and the cardiac function indexes before and after TPI treatment in the observation group were observed.The correlation among the indexes of the observation group and the prognosis of the two groups were analyzed.Results The levels of BNP and cTnI in the observation group were（112.24±17.33） pg/mL and（1.28±0.26） ng/mL,which were significantly higher than（28.53±9.82） pg/mL and（0.03±0.02） ng/mL in the control group（P〈0.05）.The left ventricular ejection fraction（LVEF） and cardiac index（CI） of the observation group after TPI treatment were（69.27±6.33）% and（4.18±0.13） L/min·m^2,which were significantly higher than（51.39±3.17）% and（3.15 ± 0.11） L/min·m^2 of the observation group before TPI treatment（P〈0.05）;the left atrial dimension（LAD） and left ventricular ends diastolic dimension（LVEDD） of the observation group after TPI treatment were（31.19±3.06） mm and（42.18±4.13） mm,which were significantly lower than（43.58±5.21） mm and（50.26±5.30） mm of the observation group before TPI treatment（P〈0.05）.The levels of BNP and cTnI of the observation group patients after treatment of TPI were（41.83 ± 9.87） pg/mL and（0.53 ± 0.07） ng/mL,which were significantly lower than（112.24 ±17.33） pg/mL and（1.28±0.26） ng/mL before treatment of TPI（P〈0.05）.According to the correlation analysis of Spearman method,in the observation group,the plasma BNP and serum cTnI were negatively correlated with LVEF and CI（r=-5.394,-7.108,-6.024,-6.138）,and were positively correlated with LAD and LVEDD（r=6.133,5.971,5.421,5.620）.In the observation group,the success rate of one-time implantation TPI treatment was 100%,and there was no obvious complication after treatment.Conclusion TPI has a good curative effect and safety in the treatment of patients with type Ⅲ-DAB.The plasma BNP and serum cTnI were negatively correlated with LVEF and CI,and were positively correlated with LAD and LVEDD,which is worthy of clinical attention.
出处
《海南医学》
CAS
2017年第3期360-362,共3页
Hainan Medical Journal
基金
重庆市卫生局医学科研计划项目(编号:2013-2-202)
关键词
临时心脏起搏器植入术
Ⅲ度房室传导阻滞
心功能
脑钠肽
心肌肌钙蛋白
Temporary pacemaker implantation（TPI）
Ⅲ degree atrioventricular block（Ⅲ-DAB）
Cardiac function（CI）
B-type natriuretic peptide（BNP）
Cardiac troponin-I（cTnI）
