CAJ | 학술논문

目的：观察肺动脉收缩压对慢性心力衰竭患者心脏再同步化治疗（ CRT）的影响。方法：对我院35例植入CRT／CRT-D患者，根据患者术前肺动脉收缩压（PASP）将研究对象分为两组：PASP＜45 mmHg（A组）、PASP≥45 mmHg（B组），观察两组患者术后6个月临床心功能，QRS波时限和左室舒张末期内径（ LVEDD）、左室射血分数（ LVEF）、左室短轴缩短率（ FS）及肺动脉收缩压等超声心动图指标的变化；观察两组患者对CRT治疗反应性的差异。结果：CRT术后6个月，两组患者PASP均显著降低；术后B组PASP仍显著高于A组；两组患者术后临床心功能均明显改善（ P＜0.01）及LVEF显著升高（ P＜0.05）；A组临床心功能改善及LVEF升高明显优于B组；而两组术后QRS波时限、LVEDD及FS无显著差异。结论：轻度PASP患者对CRT反应要优于中重度PASP患者，术前PASP对CRT反应性具有一定预测价值。
목적：관찰폐동맥수축압대만성심력쇠갈환자심장재동보화치료（ CRT）적영향。방법：대아원35례식입CRT／CRT-D환자，근거환자술전폐동맥수축압（PASP）장연구대상분위량조：PASP＜45 mmHg（A조）、PASP≥45 mmHg（B조），관찰량조환자술후6개월림상심공능，QRS파시한화좌실서장말기내경（ LVEDD）、좌실사혈분수（ LVEF）、좌실단축축단솔（ FS）급폐동맥수축압등초성심동도지표적변화；관찰량조환자대CRT치료반응성적차이。결과：CRT술후6개월，량조환자PASP균현저강저；술후B조PASP잉현저고우A조；량조환자술후림상심공능균명현개선（ P＜0.01）급LVEF현저승고（ P＜0.05）；A조림상심공능개선급LVEF승고명현우우B조；이량조술후QRS파시한、LVEDD급FS무현저차이。결론：경도PASP환자대CRT반응요우우중중도PASP환자，술전PASP대CRT반응성구유일정예측개치。
Objective:To observe the effects of pulmonary artery systolic pressure (PASP) on cardiac resynchronization therapy (CRT) in patients with chronic heart failure.Methods:Thirty-five patients with CRT/CRT-D were enrolled and divided into two groups based on preoperative PASP,i.e.,group A: PASP<45 mmHg;group B: PASP≥45 mmHg.The two groups of patients were assessed 6 month after CRT concerning the cardiac function,QRS du-ration,left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD),pulmonary artery systolic pressure (PASP) and fraction shortening ( FS) ,and compared regarding the response to CRT.Results:PASP was significantly decreased in the two groups of patients 6 months after CRT,yet higher PASP was seen in group B.Although postoperative cardiac function was improved for the two groups of patients and LVEF was notably e-valuated(P<0.05),group A had better progress and significantly elevated LVEF(P<0.05).Nevertheless,QRS duration,LVEDD and FS remained simi-lar for the two groups.Conclusion:CRT response in patients with mild PASP is superior to those with moderate to severe PASP .Preoperative measurement of PASP may have implications for predicting the response to CRT .