發(fā)布時(shí)間：2018-03-23 16:47

  本文選題：起搏器　切入點(diǎn)：人工　出處：《中國(guó)醫(yī)學(xué)影像技術(shù)》2015年09期

【摘要】：目的采用實(shí)時(shí)三維超聲心動(dòng)圖(RT-3DE)評(píng)價(jià)右心室心尖部(RVA)和間隔部(RVS)起搏對(duì)緩慢性心律失常患者左心房同步性的影響。方法將51例高度或Ⅲ度房室傳導(dǎo)阻滯患者分為RVA組(n=31)和RVS組(n=20),采用RT-3DE分別測(cè)算患者安置埋藏式心臟起搏器術(shù)前和術(shù)后1、3、6、12個(gè)月的左心房主動(dòng)射血分?jǐn)?shù)(LAAEF)、左心室射血分?jǐn)?shù)(LVEF)及左心房16節(jié)段、12節(jié)段、6節(jié)段QRS波起點(diǎn)到左心房收縮最小收縮容積的時(shí)間標(biāo)準(zhǔn)差(Tmsv-16-SD、Tmsv-12-SD、Tmsv-6-SD)及最大時(shí)間差(Tmsv-16-Dif、Tmsv-12-Dif、Tmsv-6-Dif)的變化。并對(duì)以上參數(shù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果兩組術(shù)后3、6、12個(gè)月的Tmsv-16-SD、Tmsv-12-SD及Tmsv-6-SD和兩組術(shù)后各時(shí)間點(diǎn)的Tmsv-16-Dif、Tmsv-12-Dif、Tmsv-6-Dif均分別較各組術(shù)前增高(P均0.05),RVS組術(shù)后3、6、12個(gè)月Tmsv-16-SD、Tmsv-12-SD、Tmsv-6-SD和Tmsv-16-Dif、Tmsv-12-Dif、Tmsv-6-Dif均小于同時(shí)點(diǎn)RVA組(P0.05)。RVS組6、12個(gè)月的LAAEF、LVEF均大于同時(shí)點(diǎn)RVA組(P0.05)。結(jié)論采用RT-3DE檢測(cè)的左心房各節(jié)段達(dá)最小容積的最大時(shí)間差可較時(shí)間標(biāo)準(zhǔn)差更敏感地評(píng)價(jià)右心室不同部位起搏對(duì)左心房同步性的影響。持續(xù)RVA和RVS起搏均可導(dǎo)致緩慢性心律失常患者左心房收縮運(yùn)動(dòng)失同步化,但RVS起搏的不良影響較小。
[Abstract]:Objective to evaluate the effects of RVA (right ventricular apex) and RVS (septal) pacing on synchronism of left atrium in patients with bradyarrhythmia by real-time three-dimensional echocardiography (RT-3DED). Methods 51 patients with high or third degree atrioventricular block were divided into two groups. The left atrial active ejection fraction (LAAEFF, left ventricular ejection fraction (LVEF) and left ventricular ejection fraction (LVEF) were measured by RT-3DE before and after implantation of implantable pacemaker in RVA group and RVS group, respectively. The starting point of QRS wave in 12 segments and 12 segments of left atrium were measured by RT-3DE. The time standard deviation to the minimum systolic volume of left atrium Tmsv-16-SDTmsv-12-SDTmsv-6-SD1) and the maximum time difference (Tmsv-16-DifMr Tmsv-12-DifMr Tmsv-6-Dif) were analyzed statistically. Results the mean scores of Tmsv-16-SDV Tmsv-12-Difv-12-DifTmsv-6-Dif and Tmsv-16-SDV Tmsv-12-DifTmsv-6-Dif were obtained in the two groups after operation. The levels of Tmsv-16-SDV Tmsv-6-SD and Tmsv-16-DifTmsv-6-SD and Tmsv-16-DifTmsv-6-Dif were lower than those of RVA group (P 0.05. RVS) at 12 months. Conclusion the maximum time difference of minimum volume of left atrial segment measured by RT-3DE is higher than that of RVA group at 12 months. The effects of pacing in different parts of right ventricle on left atrial synchrony were evaluated more sensitively than time standard deviations. Continuous RVA and RVS pacing could lead to the loss of synchronization of left atrial contraction in patients with bradyarrhythmia. However, the adverse effects of RVS pacing were small.
【作者單位】： 貴州省人民醫(yī)院心內(nèi)科;
【基金】：貴州省優(yōu)秀科技教育人才省長(zhǎng)資金(2012-12) 貴州省衛(wèi)生計(jì)生委科學(xué)技術(shù)基金(GZWKJ2014-1-047)
【分類號(hào)】：R540.45

【參考文獻(xiàn)】

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