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目的分析湖北地区2013~2015年心脏植入器械的应用现状。方法收集2013~2015年湖北省心脏起搏器、心脏再同步化治疗(CRT)和埋藏式心脏转复除颤器(ICD)的应用数据,分析3年间的变化趋势。结果 2013~2015年,湖北地区心脏起搏器植入量呈增长趋势,2014年和2015年分别增长了1.08%和7.65%;双腔起搏器和频率应答功能的比例逐年增加,单腔心室按需起搏器植入逐年减少(分别为40.65%、37.82%、36.48%);而适应证构成比相近。CRT的植入量也呈逐年增长,2014年和2015年的增长率分别为26%和8.73%;以非缺血性心脏病和左束支阻滞患者植入为主(分别为80%、80.95%、71.53%和75%、84.92%、77.37%);NYHA心功能I级患者逐渐增多(分别为1%、2.38%、8.03%)。ICD植入总量未见持续增长,2014年增长了20%,2015年下降了15.79%,主要用于SCD二级预防和器质性心脏病患者。结论既往3年间,湖北地区心脏起搏器和CRT治疗的量和质均有所提高,但是ICD治疗发展缓慢,心脏性猝死预防工作仍较艰巨。
Objective To analyze the current status of heart implanted devices in Hubei Province from 2013 to 2015. Methods Data of pacemaker, cardiac resynchronization therapy (CRT) and cardioverter defibrillator (ICD) collected in Hubei province from 2013 to 2015 were collected to analyze the trend of change in three years. Results From 2013 to 2015, the implantation rate of pacemaker in Hubei showed an increasing trend, increasing by 1.08% and 7.65% respectively in 2014 and 2015. The proportion of dual-chamber pacemaker and frequency response increased year by year. The single-chamber ventricular On-demand pacemaker implants decreased year by year (40.65%, 37.82%, 36.48%, respectively); and the indications constituted a similar ratio. The implantation volume of CRT also increased year by year, with the growth rates of 26% and 8.73% in 2014 and 2015 respectively. The patients with non-ischemic heart disease and left bundle branch block were the main recipients (80% 80.95%, 71.53% and 75%, 84.92% and 77.37%, respectively). NYHA functional class I patients gradually increased (1%, 2.38% and 8.03% respectively). The total ICD implants have not seen sustained growth, an increase of 20% in 2014 and a 15.79% decrease in 2015, mainly for secondary prevention of SCD and organic heart disease. Conclusion The volume and quality of pacemaker and CRT in Hubei Province have been improved in the past three years. However, the slow development of ICD and the prevention of sudden cardiac death are still arduous.