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目的探讨起搏器植入患者单腔和双腔起搏对中心动脉压(CAP)和动脉波增强指数(AI)的不同影响及临床意义。方法顺序入选103例植入起搏器患者,其中植入双腔起搏器患者42例为DDD组,单腔起搏器患者41例为VVI组,植入起搏器但患者心率为正常窦性心律者20例为对照组,分别测量三组患者的心率(HR)、CAP、AI、外周收缩压、外周舒张压等指标,随后将双腔起搏组的DDD模式程控成VVI模式,再次测量上述指标,记录并进行统计。结果 DDD组CAP明显高于对照组和VVI组[(149.67±19.62)mmHg vs(138.70±18.69)mmHg,(124.33±19.34)mmHg,P<0.05];DDD组AI、AI_C和外周血压均高于VVI组(P<0.05);程控后的CAP、AI、AI_C和外周动脉血压水平均低于程控前(P<0.05)。结论双腔起搏组的CAP、AI和外周动脉血压均高于单腔起搏组。而CAP和AI的升高可能是双腔起搏较单腔起搏并未改善远期预后的原因之一。
Objective To investigate the differential effects of single and double-chamber pacing on central arterial pressure (CAP) and arterial pressure enhancement (AI) in pacemaker-implanted patients and its clinical significance. METHODS: A total of 103 patients with pacemaker implantation were enrolled in this study. Among them, 42 patients underwent double-chamber pacemaker implantation as DDD group and 41 patients underwent single-chamber pacemaker implantation as VVI group. However, Ventricular arrhythmia (HR), CAP, AI, peripheral systolic pressure, and peripheral diastolic pressure were measured in 20 patients with ventricular arrhythmias. The DDD mode of dual-chamber pacing group was programmed into VVI mode. Measure the above indicators, record and make statistics. Results The CAP in DDD group was significantly higher than that in control group and VVI group [(149.67 ± 19.62) mmHg vs (138.70 ± 18.69) mmHg, (124.33 ± 19.34) mmHg, P <0.05] VVI group (P <0.05). The levels of CAP, AI, AI_C and peripheral arterial pressure were lower than those before treatment (P <0.05). Conclusions The CAP, AI and peripheral arterial pressure in dual chamber pacing group are higher than those in single chamber pacing group. The rise of CAP and AI may be one of the reasons that double-chamber pacing does not improve the long-term prognosis than single-chamber pacing.