【作者】 赵阳；

【导师】 汤宝鹏；

【作者基本信息】 新疆医科大学 ， 心血管， 2006， 硕士

【摘要】 目的：观察老年病态窦房结综合征患者，植入频率适应性起搏器后生活质量、心脏功能及运动耐量等改变，以探讨频率适应性起搏器对老年患者生活质量的影响。方法：经临床、食管心房调搏、动态心电图和运动试验确诊且合并窦房结变时功能不全的30例老年病态窦房结综合征患者，择期植入永久双腔频率适应性起搏器(DDDR)，于起搏器植入术后即刻及12个月后将起搏器分别程控为非频率适应性起搏模式(DDD)和频率适应性起搏模式(DDDR)。两种模式下起搏器各工作12个月，定期随访，采用SF-36生活质量调查表，进行问卷调查；动态心电图(DCG)监测24小时日常活动时心率变化：症状限制性活动平板运动试验观察运动持续时间，最大起搏频率：超声心动图测定最大运动负荷时每搏量、每分心输出量。结果：本组患者DDDR模式下与DDD模式下相比SF-36调查表的总得分差别有统计学意义(118.6±7.12 VS 95.27±7.56，t=12.31，P＜0.001)：运动持续时间和最大心输出量差别亦有统计学意义(386.20±67.72s VS 274.10±56.88s，t=6.94，P＜0.001；9.97±1.03l／min VS 6.30±0.79 l／min，t=15.41，P＜0.001)。最大运动负荷时两种起搏模式的每搏量差别无统计学意义(71.57±5.35ml VS 70.67±5.42ml，t=0.65，P=0.52)。结论：频率适应性起搏器可明显改善老年病态窦房结综合征患者的生活质量和运动耐量。更多还原

【Abstract】 Objective: To investigate the effect on Quality-of-Life(QOL) of rate adaptive pacemaker in old patients with sick sinus symptom(SSS). Methods: 30 old patients had SSS accompanied with chronotropic incompetence in terms of clinical manifestation, h olter and tread mill were implanted the dual chamber pacing(DDDR). Pacemakers were respectively programmed without and with adaptive demand mode in the implantation instantly and 12months later. The SF-36 was used to measure quality of life without and with adaptive demand mode, the pacing rate, cardiac out-put and exercise capacity were measured by tread mill, echocardiography and holter during exercise test and daily activities in tow different mode. Results: The scores of SF-36 were significantly increased (118.6±7.12 VS 95.27±7.56, t=12.31, P<0.001) in DDDR mode and the scores about five aspects of SF-36, which included physical functioning, physical role, general health, vitality and social functional were better than in DDD mode.(except for body pain, emotional role and mental health).Compared with DDD mode, the exercise time and cardiac out-put of 30 patients were significantly increased(386.20±67.72s VS 274.10±56.88s, t=6.94, P<0.001; 9.97±1.03 1/ min VS 6.30±0.79 1/ min, t=15.41, P<0.001). However there were no significant difference between the tow mode in the stroke volume (71.57±5.35ml VS 70.67±5.42ml, t=0.65, P=0.52) Conclusions: The implantation of DDDR improves health-related quality of life, meet with requirement of更多还原