【摘要】 目的:探讨Tei指数和血浆N末端B型利钠肽原(NT-proBNP)水平对起搏器患者术后心功能评价的价值。方法:行永久起搏器植入术患者168例,起搏模式均为心室按需起搏(VVI),术前,术后3个月、12个月行Tei指数、血清NT-proBNP、左室射血分数(LVEF)及E/A峰比值等检测,计算心室累积起搏(CumVP)比例(%)。按心室起搏比例区分为CumVP<30%组(38例),CumVP 30%～75%组(56例),CumVP>75%组(74例)3组。分析Tei指数与NT-proBNP在不同起搏指数患者之间的变化。结果:与术前比较,术后12个月Cum-VP>75%组NT-proBNP[(124.88±12.56)ng/L比(168.42±32.46)ng/L]与Tei指数[(0.52±0.04)比(0.68±0.06)]显著升高(P<0.05～<0.01),LVEF[(0.56±0.02)比(0.48±0.05)]显著降低(P<0.05);与术前比较,术后CumVP<30%组上述指标的变化差异无显著性(P>0.05),CumVP 30%～75%组,Tei指数明显升高[(0.54±0.14)比(0.66±0.01),P<0.05],而BNP、LVEF变化差异无显著性(P>0.05)。结论:起搏器患者心功能改变与起搏比例有关,N末端B型利钠肽原水平与Tei指数可作为评价术后心功能的指标。更多还原

【Abstract】 Objective:To investigate the value evaluating cardiac function with Tei index and plasma level of N-terminal pro B-type natriuretic peptide(NT-proBNP) in patients after implantation of pacemaker.Methods:There were 168 patients with implantation of permanent pacemaker and their pacing modes were all ventricular demand pacing(VVI).Tei index,serum level of NT-proBNP,left ventricular ejection fraction(LVEF) and ratio of E/A was measured before,three months and 12 months after operation,and ventricular cumulative pacing percent(CumVP %) was calculated.All patients were classified into CumVP<30% group(38 cases),30%~75% group(56 cases),and >75% group(74 cases).Changes of Tei index and NT-proBNP level were analyzed in three groups.Results:Compared with before operation,there were significant increase in NT-proBNP [(124.88±12.56) ng/L vs.(168.42±32.46) ng/L]and Tei index [(0.52±0.04) vs.(0.68±0.06)],decrease in LVEF [(0.56±0.02)vs.(0.48±0.05)]in CumVP>75% group on 12 months after operation(P<0.05~<0.01).There were no significant difference in above index in CumVP<30% group before and after operation(P>0.05).Compared with before operation,there was significant increase in Tei index [(0.54±0.14) vs.(0.66±0.01),P<0.05],but NT-proBNP and LVEF were no significant(P>0.05) in CumVP 30%~75% group.Conclusion:Change of cardiac function is related with ventricular cumulative pacing percent in patients with pacemaker.Level of N-terminal B type natriuretic peptide and Tei index can be used for evaluating cardiac function after operation.更多还原