不同起搏方式治疗病窦综合征的近远期疗效对比

摘要

目的：对比分析AAI与DDD两种起搏方式治疗病窦综合征（SSS）的临床疗效。方法：选取入医院行起搏器置入的病窦综合征患者82例作为研究对象，根据患者起搏器方式将患者分为两组，分别为AAI起搏组（42例）和DDD起搏器组（40例），术后1周观察两组患者超声以及心电图指标，随访2年，采用心功能分级标准（NYHA）评估两组患者的心功能，并观察预后效果。结果：AAI起搏组AVTI值为（29.67±3.64）较DDD起搏组高，QRS宽度为（97.36±12.26）ms较DDD起搏组低，两组比较差异具有统计学意义（P<0.05）。随访2年，AAI起搏组心功能Ⅰ级人数占69.05%较DDD起搏组35.00%高，心功能Ⅱ级人数占30.85%较DDD起搏组57.5%低，两组比较差异具有统计学意义（P<0.05）。AAI起搏组房颤的发生率为9.52%较DDD起搏组27.50%低，两组比较差异具有统计学意义（P<0.05）。结论：病窦综合征采用AAI起搏可减少对心功能的影响，可提高远期疗效。%Objective:To comparative analysis the clinical curative effect of two pacing modes of AAI and DDD in treatment of sick sinus syndrome(SSS).Method:82 patients of sick sinus syndrome were selected for pacemaker into the hospital as research object,according to the way of pacemaker patients were divided into two groups,AAI pacing group of 42 cases and DDD pacemaker group of 40 cases,two groups of patients with ultrasound and ECG parameters after operation 1 week later were observed.Follow-up 2 years two groups of patients were used the cardiac functional grading standards(NYHA),the cardiac function was evaluated and the prognosis was observed.Result:In AAI pacing group, the AVTI value was(29.67±3.64),higher than DDD pacemaker group,QRS width of(97.36±12.26)ms ,was lower than DDD pacing group,the differences were statistically significant(P<0.05). Follow-up 2 years,AAI pacing group of heart function grade number accounted for 69.05%,was higher than DDD pacing group of 35.00%,heart function grade II accounted for 30.85%was lower than DDD pacemaker group of 57.5%,the differences were statistically significant (P<0.05). The atrial fibrillation incidence rate in AAI pacing group of 9.52%,was lower than DDD pacemaker group of 27.50%,the difference was statistically significant(P<0.05). Conclusion:The sick sinus syndrome with AAI pacing can reduce the effects of cardiac function,improve curative effect.