孙贤林,严激,徐健,范西真,安春生,刘伏元,丁小梅,顾统元

• 1:安徽医科大学附属省立医院心内科

摘要(Abstract)：

目的评价房室(AV)间期动态优化的心脏再同步治疗对慢性心力衰竭的疗效。方法63例因心力衰竭接受心脏再同步治疗的患者分别于植入起搏器术后1周、6个月及12个月在超声指导下行AV间期优化。定义最佳AV间期为超声心动图指标E、A峰最大分离并无切尾。同时分别行超声心动图及心电图、6分钟步行距离试验(6MHW)、明尼苏达HF患者生活质量问卷评分(QOL)。结果本组最佳优化AV间期在90～140(110.45±19.47)ms。CRT植入后1周同植入前比较,左室射血分数(LVEF,22.07%±6.77%比18.53%±4.83%)和左心室舒张期充盈时间(LVFT,293.27±24.79ms比272.35±56.00ms)明显提高,QRS波宽度变窄(129.40±6.65ms比138.25±28.00ms),P均<0.05,差异有统计学意义。跟优化前比,AV间期动态优化后的6个月和12个月LVEF值由22.07%±6.77%增加至32.24%±10.34%及36.86%±9.29%;6min步行距离(6MHW)由术前268.70±22.25m增加至327.12±15.24m及347.62±15.04m;QRS时限无明显变化;左心室舒张末期直径(LVEDD)由71.43±7.12mm降至65.88±9.85mm和57.06±6.54mm;生活质量问卷评分(QOL)由72.14±6.24降低至61.68±12.28和55.15±11.02;NHYA心功能分级由3.12±0.55减至1.68±0.67和1.82±0.43。结论动态优化AV间期可以提高心脏再同步治疗对慢性心力衰竭的短期、中期、远期疗效。

关键词(KeyWords)： 心脏起搏,人工;心力衰竭,充血性;超声心动描记术

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孙贤林,严激,徐健,范西真,安春生,刘伏元,丁小梅,顾统元

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