中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2012年
6期
442-445
,共4页
朱莉%阮中宝%陈各才%任寅%陈铭%朱俊国%殷屹岗
硃莉%阮中寶%陳各纔%任寅%陳銘%硃俊國%慇屹崗
주리%원중보%진각재%임인%진명%주준국%은흘강
心脏再同步治疗%血清胱抑素C%疗效
心髒再同步治療%血清胱抑素C%療效
심장재동보치료%혈청광억소C%료효
Cardiac resynchronization therapy%Serum cystatin C%Effect
目的 了解心脏再同步治疗(CRT)前后血清胱抑素C(CysC)水平的变化,探讨CysC变化水平是否能反映CRT植入后心力衰竭患者心脏结构和功能改善程度.方法 对本院16例植入CRT/心脏再同步治疗除颤器(CRT-D)患者的随访资料进行分析,随访时间均＞6个月,平均随访(20.08±12.78)个月.根据治疗效果将患者分为有效组和无效组,有效定义为术后左心室收缩末容积缩小≥15％.结果 16例中有效10例(62.5％).有效组术后CysC水平明显降低[(1.54±0.38)对(1.22±0.29) P＜0.05];与临床及超声心动图指标比较,CysC在CRT术后1个月即出现明显变化且差异有统计学意义(P＜0.05).无效组术后各个时间点随访参数与术前相比均差异无统计学意义.而有效组术后6个月相关参数均明显优于无效组,但只有CysC在术后1个月即与无效组存在明显差异,且随时间延长,其差异越明显.随访时间≥6个月时,CysC水平的降低幅度(△Cys C％)与左心室舒张末期容积(LVEDV)缩小幅度(△LVEDV％)呈线性相关(R2=0.792,P＜0.05)；无效组术后CysC与术前相比差别无统计学意义；CysC水平的变化与△LYEDV％无线性回归关系(P＞0.05).结论 血清CysC是一个有效地、较临床及超声心动图指标能更早的、可以常规用来监测CRT对于心力衰竭治疗效果的指标,可以更好地用于指导心力衰竭的再同步治疗.
目的 瞭解心髒再同步治療(CRT)前後血清胱抑素C(CysC)水平的變化,探討CysC變化水平是否能反映CRT植入後心力衰竭患者心髒結構和功能改善程度.方法 對本院16例植入CRT/心髒再同步治療除顫器(CRT-D)患者的隨訪資料進行分析,隨訪時間均＞6箇月,平均隨訪(20.08±12.78)箇月.根據治療效果將患者分為有效組和無效組,有效定義為術後左心室收縮末容積縮小≥15％.結果 16例中有效10例(62.5％).有效組術後CysC水平明顯降低[(1.54±0.38)對(1.22±0.29) P＜0.05];與臨床及超聲心動圖指標比較,CysC在CRT術後1箇月即齣現明顯變化且差異有統計學意義(P＜0.05).無效組術後各箇時間點隨訪參數與術前相比均差異無統計學意義.而有效組術後6箇月相關參數均明顯優于無效組,但隻有CysC在術後1箇月即與無效組存在明顯差異,且隨時間延長,其差異越明顯.隨訪時間≥6箇月時,CysC水平的降低幅度(△Cys C％)與左心室舒張末期容積(LVEDV)縮小幅度(△LVEDV％)呈線性相關(R2=0.792,P＜0.05)；無效組術後CysC與術前相比差彆無統計學意義；CysC水平的變化與△LYEDV％無線性迴歸關繫(P＞0.05).結論 血清CysC是一箇有效地、較臨床及超聲心動圖指標能更早的、可以常規用來鑑測CRT對于心力衰竭治療效果的指標,可以更好地用于指導心力衰竭的再同步治療.
목적 료해심장재동보치료(CRT)전후혈청광억소C(CysC)수평적변화,탐토CysC변화수평시부능반영CRT식입후심력쇠갈환자심장결구화공능개선정도.방법 대본원16례식입CRT/심장재동보치료제전기(CRT-D)환자적수방자료진행분석,수방시간균＞6개월,평균수방(20.08±12.78)개월.근거치료효과장환자분위유효조화무효조,유효정의위술후좌심실수축말용적축소≥15％.결과 16례중유효10례(62.5％).유효조술후CysC수평명현강저[(1.54±0.38)대(1.22±0.29) P＜0.05];여림상급초성심동도지표비교,CysC재CRT술후1개월즉출현명현변화차차이유통계학의의(P＜0.05).무효조술후각개시간점수방삼수여술전상비균차이무통계학의의.이유효조술후6개월상관삼수균명현우우무효조,단지유CysC재술후1개월즉여무효조존재명현차이,차수시간연장,기차이월명현.수방시간≥6개월시,CysC수평적강저폭도(△Cys C％)여좌심실서장말기용적(LVEDV)축소폭도(△LVEDV％)정선성상관(R2=0.792,P＜0.05)；무효조술후CysC여술전상비차별무통계학의의；CysC수평적변화여△LYEDV％무선성회귀관계(P＞0.05).결론 혈청CysC시일개유효지、교림상급초성심동도지표능경조적、가이상규용래감측CRT대우심력쇠갈치료효과적지표,가이경호지용우지도심력쇠갈적재동보치료.
Objective To observe the change of serum cystatin C (CysC) level before and after cardiac resynchronization therapy(CRT) in patients with chronic heart failure (CHF).Methods A retrospective review of 16 patients with CRT/CRT-D was conducted.Patients have been followed up for at least 6 months.The patient whose left end-systolic volume decreased by 15％ after implantationwas considered as responder to CRT.Results During the mean follow-up of (20.1 ± 12.8)months,10 responders were identified.After the implantation,the level of serum CysC decreased significantly in theresponder group (1.54± 0.38 vs.1.22 ±0.29,P＜0.05),which was in a linear regression relationship with the variation of left ventricularend-diastolic volume (R2 =0.792,P＜0.05).However,there was no such linear regression relationship existed in nonrespondergroup.Compared with the clinical and Echocardiographyparameters,the serum CysC level in theresponder group was decreased significantly one month after CRT.Conclusion Serum CysC level was a valuable marker in evaluating the effect of CRT in CHF patients.
