中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2014年
4期
280-282,308
,共4页
陈康玉%严激%徐健%孙贤林%安春生%苏浩%胡凯%章超惠
陳康玉%嚴激%徐健%孫賢林%安春生%囌浩%鬍凱%章超惠
진강옥%엄격%서건%손현림%안춘생%소호%호개%장초혜
心脏再同步治疗%慢性心力衰竭%肾功能不良%慢性肾脏疾病
心髒再同步治療%慢性心力衰竭%腎功能不良%慢性腎髒疾病
심장재동보치료%만성심력쇠갈%신공능불량%만성신장질병
Cardiac resynchronization therapy%Chronic heart failure%Renal dysfunction%Chronic kidney disease
目的 通过观察患者心脏再同步治疗(CRT)前后肾功能的变化情况,旨在探讨肾功能对CRT疗效的影响.方法 选取2001年12月至2012年11月间202例在安徽省立医院植入CRT的患者,分别在术前、术后1个月和6个月检测患者的肾功能,通过估计的肾小球滤过率(eGFR)来评价肾功能水平.术后随访6个月,观察患者肾功能的变化情况以及与CRT疗效的关系.结果 共入选202例CRT患者,有40例(1 9.8％)患者符合慢性肾功能不良(CKD)标准,与非CKD组相比,CKD组患者的年龄大、缺血性心肌病多.术后有146例(72.3％,有反应组)CRT有效,有反应组患者在术后6个月时肾功能显著改善.根据术前eGFR水平的不同,将CRT患者分为肾功能中重度损害组、轻度损害组和正常组,各组患者的CRT疗效差异有统计学意义(P=0.024),随着肾功能的下降,CRT疗效逐渐变差.结论 术前eGFR水平与CRT的疗效显著相关,随着肾功能的下降,CRT疗效逐渐变差.同时,CRT亦可改善肾功能,在术后6个月时更为显著.
目的 通過觀察患者心髒再同步治療(CRT)前後腎功能的變化情況,旨在探討腎功能對CRT療效的影響.方法 選取2001年12月至2012年11月間202例在安徽省立醫院植入CRT的患者,分彆在術前、術後1箇月和6箇月檢測患者的腎功能,通過估計的腎小毬濾過率(eGFR)來評價腎功能水平.術後隨訪6箇月,觀察患者腎功能的變化情況以及與CRT療效的關繫.結果 共入選202例CRT患者,有40例(1 9.8％)患者符閤慢性腎功能不良(CKD)標準,與非CKD組相比,CKD組患者的年齡大、缺血性心肌病多.術後有146例(72.3％,有反應組)CRT有效,有反應組患者在術後6箇月時腎功能顯著改善.根據術前eGFR水平的不同,將CRT患者分為腎功能中重度損害組、輕度損害組和正常組,各組患者的CRT療效差異有統計學意義(P=0.024),隨著腎功能的下降,CRT療效逐漸變差.結論 術前eGFR水平與CRT的療效顯著相關,隨著腎功能的下降,CRT療效逐漸變差.同時,CRT亦可改善腎功能,在術後6箇月時更為顯著.
목적 통과관찰환자심장재동보치료(CRT)전후신공능적변화정황,지재탐토신공능대CRT료효적영향.방법 선취2001년12월지2012년11월간202례재안휘성립의원식입CRT적환자,분별재술전、술후1개월화6개월검측환자적신공능,통과고계적신소구려과솔(eGFR)래평개신공능수평.술후수방6개월,관찰환자신공능적변화정황이급여CRT료효적관계.결과 공입선202례CRT환자,유40례(1 9.8％)환자부합만성신공능불량(CKD)표준,여비CKD조상비,CKD조환자적년령대、결혈성심기병다.술후유146례(72.3％,유반응조)CRT유효,유반응조환자재술후6개월시신공능현저개선.근거술전eGFR수평적불동,장CRT환자분위신공능중중도손해조、경도손해조화정상조,각조환자적CRT료효차이유통계학의의(P=0.024),수착신공능적하강,CRT료효축점변차.결론 술전eGFR수평여CRT적료효현저상관,수착신공능적하강,CRT료효축점변차.동시,CRT역가개선신공능,재술후6개월시경위현저.
Objective To explore the impact of renal function on cardiac resynchronization therapy (CRT) by observing the variation of renal function before and after pacemaker implantation.Methods Patients underwent CRT were enrolled in this study from December 2001 to November 2012.Renal function was assessed by estimated glomerular filtration rate (eGFR),and was detected before,one month and six months after CRT.The variation of renal function and its relationship with effect of CRT were evaluated during six-month follow-up.Results Two hundreds and two patients were included in this study,40 (19.8％) of whom had chronic kidney disease(CKD).Patients with CKD were older and more likely to had ischemic cardiomyopathy than patients without CKD.One hundred and forty-six patients (72.3％,response group) responded to CRT.Renal function was significantly improved after six months of CRT.Patients were divided into moderate and severe decreased renal function group,mildly decreased renal function group and control,according to the level of eGFR.There were significant difference in the effect of CRT among the three groups (P=0.024).With the decrease of renal function,the effect of CRT was decreased.Conclusion The level of baseline eGFR is associated with the effect of CRT.With the decrease of renal function,the effect of CRT declines.Renal function also can be improved after six months of CRT.
