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目的观察心脏再同步化治疗(CRT)慢性心力衰竭(CHF)患者的临床疗效。方法选择2008年1月至2009年8月行CRT的患者32例,其中12例植入再同步心脏转复除颤器(CRT-D)。32例中30例为窦性心律,2例为房颤心律。随访21.5±6.2个月,观察患者NYHA心功能分级、QRS波时限、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、6分钟步行距离(6MWD)、因心功不全住院时间等。结果 32例植入CRT(D)患者中,有24例临床症状明显改善,心功分级降低,LVEF和6MWD增加,QRS波时限、LVEDD减少,因心功不全住院时间明显减少约24.5%(p<0.05)。8例患者心功能没有明显改善,但因心功不全住院时间减少约8.3%(p<0.05)。4例患者记录到室性心律失常事件(12.5%),2例室速经抗心动过速起搏(ATP)有效转复,2例患者因室颤而放电,均成功转复,CRT-D均能有效识别和转复。结论 CRT可明显改善CHF患者的心功能,提高生活质量,缓解临床症状,植入CRT-D可有效预防心源性猝死(SCD)。
Objective To observe the clinical effect of cardiac resynchronization therapy (CRT) in patients with chronic heart failure (CHF). Methods Thirty-two patients undergoing CRT from January 2008 to August 2009 were enrolled. Twelve of them were implanted with CRT-D. Thirty cases were sinus rhythm in 32 cases and two cases were atrial fibrillation rhythm. The patients were followed up for 21.5 ± 6.2 months. NYHA functional class, QRS wave length, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), 6-minute walking distance Wait. Results Among the 32 patients with CRT (D), 24 patients showed significant improvement in clinical symptoms, decreased heart function, increased LVEF and 6MWD, decreased QRS duration and LVEDD, and significantly reduced hospital stay due to cardiac insufficiency by about 24.5% (p <0.05). There was no significant improvement in cardiac function in 8 patients, but hospitalization for cardiac insufficiency was reduced by about 8.3% (p <0.05). Four patients recorded ventricular arrhythmia (12.5%), two were ventricular tachycardia (ATP), and two patients were discharged due to ventricular fibrillation. Can effectively identify and recovery. Conclusions CRT can significantly improve cardiac function, improve quality of life and relieve clinical symptoms in patients with CHF. CRT-D can effectively prevent sudden cardiac death (SCD).