右室不同部位起搏对血浆IL-6、ANP水平和左心功能的影响
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国家自然科学基金(81170162)


The influence of cardiac pacemaker implantation site on plasma interleukin-6,atrial natriuretic peptide and left ventricular function
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    摘要:

    目的:通过比较右心室心尖部(RVA)和右心室中位间隔部(mid-RVS)两种不同部位起搏早期对患者血浆白细胞介素-6(IL-6)-血浆心房利钠肽(ANP)水平和左心功能的影响,探讨IL-6-ANP水平与无症状左心收缩功能(ALVD)不全的相关性-方法:将42例植入DDD型起搏器患者随机分为RVA起搏组-mid-RVS起搏组,观察两组患者起搏器植入术前及术后3个月和6个月血浆IL-6-ANP水平-左房内径(LAD)-左室舒张末期内径(LVEDD)-左室射血分数(LVEF)以及心电图QRS波时限的变化-结果:术前和术后3个月比较,两组患者血浆IL-6-ANP水平和LAD-LVEDD-LVEF等均无明显差异;术后6个月RVA起搏组血浆IL-6-ANP水平和LAD-LVEDD较mid-RVS起搏组显著升高 (P < 0.01);RVA起搏组术后6个月与术前-术后3个月比较,IL-6-ANP水平和LAD-LVEDD等明显升高(P < 0.05),LVEF有降低趋势-术后mid-RVS起搏组QRS波时限明显小于RVA起搏组(P < 0.001)-结论:右室中间隔起搏有助于避免常规右室心尖部起搏导致的血浆IL-6和ANP水平增高以及左房-左室的扩大,可能减少心力衰竭的发生-

    Abstract:

    Objective:To investigate the influence of different cardiac pacemaker implantation site on plasma interleukin-6(IL-6),atrial natriuretic peptide(ANP) and left ventricular systolic function. Methods:Forty-two patients with DDD pacing were randomly divided into two groups:right ventricular apex pacing group (RVA,n = 20) and middle right ventricular septum pacing group (mid-RVS,n = 22). The plasma IL-6,ANP level,LAD,LVEDD,LVEF and QRS complex duration of pre-operation and post-operation were tested. Results:There was no statistical significance of IL-6,ANP level and LAD,LVEDD,LVEF between two groups before implantation and three months after implantation. The plasma leves of IL-6,ANP and LAD,LVEDD in RVA pacing group were higher than those in mid-RVS pacing group six months after implantation(P < 0.01). The plasma leves of IL-6,ANP and LAD,LVEDD in RVA pacing group six months after implantation were higher than those pre-implantation and three months after implantation(P < 0.01). The pacing QRS complexs duration was shorter in mid-RVS pacing group than that in RVA pacing group. Conclusion:Compared with the RVA pacing,mid-RVS pacing can avoid the elevation of IL-6,ANP level,left artial and ventricular dilation and the impairment of left ventricular systolic function.

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李文华,李 勇,季建国,徐 波,蔡高军,周惠芬,黄艳红,何国平,邹建刚.右室不同部位起搏对血浆IL-6、ANP水平和左心功能的影响[J].南京医科大学学报(自然科学版),2012,(9):1254-1258

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  • 收稿日期:2012-04-22
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