【摘要】 目的观察永久性抗缓慢型心律失常起搏器植入对心肌细胞损伤因子及 D-二聚体(D-dimer)的影响,并且比较单腔及双腔起搏器对二者的影响程度。方法入选永久性抗缓慢型心律失常起搏器植入患者19例。分别于术前、术后24 h 和术后7 d 抽血,检测肌钙蛋白 I(cTnI)、肌红蛋白(myoglobin,Mb)、肌酸激酶-同工酶(MBisoenzyme of creatine kinase,CK-MB)和 D-dimer,观察其变化的规律。结果术后24 h cTnI 水平与术前比较差异有统计学意义(P<0.05);术后7 d cTnI 与术前比较差异无统计学意义(P>0.05)。术后24 h Mb 与术前及术后7 d 与术前比较差异均无统计学意义(P>0.05)。术后24 h CK-MB 与术前比较及术后7 d 与术前比较差异均无统计学意义(P>0.05)。术后24 h D-dimer 阳性率与术前比较及术后7 d 与术前比较差异均有统计学意义(P<0.05)。双腔起搏器植入者术后24 h cTnI 水平与单腔起搏器植入者相比似有增高趋势,但差异无统计学意义(P>0.05)。双腔起搏器植入者术后24 h D-dimer 阳性率与单腔起搏器植入者二者比较差异有统计学意义(P<0.05)。其余指标单腔与双腔起搏器比较差异均无统计学意义(P>0.05)。结论永久性起搏器植入可以导致心肌细胞损伤因子的增高及机体凝血和纤溶系统的激活,这种现象在双腔起搏器植入的患者似乎更为明显。更多还原

【Abstract】 Objective To observe the influence of transvenous implantation of a permanent antibradycardia pacemaker on plasma levels of cardiac injury marker and D-dimer,and compare degree of the influence between single-chamber and dual-chamber pacemarker.Methods Nineteen patients were enrolled.The blood samples were drawn before procedure,twenty four hours after procedure and seven days after procedure.The level of cTnI,Myoglobin,MB isoenzyme of creatine kinase(CK-MB) and D-dimer were tested and analysed.Results There was a significant difference between the value of cTnI before operation and twenty-four hours after operation.There was no difference between the values of Myoglobin before operation,twenty-four hours after operation and seven days after operation.There was no difference between the values of CK-MB before operation,twenty-four hours after operation and seven days after operation.There were significant difference between the positive rate of D-dimer before operation,twenty-four hours after operation and seven days after operation.The level of cTnI twenty four hours after operation in the dual- chamber pacemaker group was higher than that of the single-chamber pacemaker group,but there was no statistic difference.But the positive rate of D-dimer twenty-four hours after operation in the dual-chamber pacemaker group had a significant difference when compare with that of the single-chamber pacemarker group.Conclusion The implantation of a permanent pacemaker may cause elevation of cardiac injury marker and D-dimer,the phenomenon maybe more apparent in the dual-chamber pacemaker group.更多还原