起搏器植入对80岁以上老年人心功能影响的临床研究

摘要

目的 探讨起搏器植入对≥80岁老年人心脏结构和功能的影响. 方法 观察2007年11月至2010年8月在我院老年病房住院的植入永久性起搏器的年龄≥80岁老年患者及同期住院且年龄、性别等相匹配的无起搏器植入的患者,比较2组患者血浆氮末端脑利钠肽前体(NT-proBNP)水平、心脏超声相关参数等指标.结果 与对照组相比,起搏器组血浆NT-proBNP水平显著升高,校正心衰、肾功能不全、贫血等因素后,这种差别依然显著；起搏器组左室射血分数(LVEF)显著下降,左房内径扩大、左室收缩末内径增大,室间隔、左室后壁增厚,左室质量指数增加,差异均有统计学意义. 结论 起搏器植入对≥80岁老年人心脏结构和功能有一定的影响.%Objective To explore the effect of pacemaker implantation on the structure and function of heart in elderly patients aged 80 and over. Methods The clinical data of old in-patients( ≥80 years old) with or without pacemaker implantation in our hospital during November 2007 to August 2010 were analyzed to find whether there were any differences in serum level of NT-proBNP and the parameters of echocardiography between two groups. Results The serum level of NT-proBNP was significantly higher in pacemaker group than that of control group. After adjusted for heart failure, chronic renal failure and anemia, there was significant correlation between pacemaker implantation and levels of NT-proBNP. Patients with pacemaker showed lower LVEF and higher left atrial diameter, left ventricular systolic dimension, in-terventricular septum, posterior left ventricle, left ventricular mass index. Conclusions Implanted pacemaker shows adverse effect on structural and function of heart in elderly patients aged 80 and over.