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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2015年第6期

页码:

690-694

栏目:

临床研究

出版日期:

2015-07-15

文章信息/Info

Title:

Factors influencing prognosis of survival rate of patients with pacemakers

作者:

刘入源¹; 周贤惠²; 张燕一²; 李晋新²; 李耀东²; 邢 强²; 汤宝鹏²

(1.新疆心脑血管病医院心内科，新疆 乌鲁木齐 830011；
2.新疆医科大学第一附属医院心脏中心起搏电生理科，新疆 乌鲁木齐 830054)

Author(s):

LIU Ru-yuan¹;  ZHOU Xian-hui²;  ZHANG Yan-yi²;  LI Jin-xin²;  LI Yao-dong²;  XING Qiang²;  TANG Bao-peng²

(1.Department of Cardiology, Xinjiang Cardiovascular and Cerebrovascular Disease Hospital, Urumqi 830011, Xinjiang, China；
2.Department of Pacing Electrophysiology, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, Xinjiang, China)

关键词:

起搏器; 随访研究; 生存预后; 预后因素

Keywords:

permanent pacemaker;  follow-up study;  prognosis of survival;  prognosis factors

分类号:

R541.7

DOI:

-

文献标识码:

A

摘要:

目的 通过连续随访起搏器植入患者,观察长期右室起搏的患者生存情况及可能影响预后的危险因素。方法 自1991年1月~2010年12月，因II度II型房室传导阻滞、III度房室阻滞、心房纤颤伴长间隙以及病态窦房结综合征等症状性缓慢心律失常植入永久起搏器的患者1 245例，自植入起搏器后进行连续随访，收集患者起搏器植入时的一般信息特征及伴随的疾病。采用Kaplan-Meier方法评估患者生存率。采用log Rank检验评价，单因素分析影响起搏器植入患者预后的危险因子，Cox多因素分析评估影响生存预后的独立危险因素。结果 在3~23年的随访中，总的生存率为91.3%；5年生存率、10年生存率、15年生存率、>20年生存率分别为92.9%，88.7%，81.9%和75.1%；单因素分析影响起搏器患者生存预后的危险因子有：年龄、性别、起搏模式、慢性肾功能衰竭、缺血性心肌病、扩张型心肌病；Cox多因素分析，影响起搏器植入患者生存预后的独立危险因素是：年龄、缺血性心肌病、扩张型心肌病。结论 植入永久心脏起搏器患者的寿命显著延长，影响起搏器植入患者生存预后的独立危险因素是：起搏器植入时的年龄、缺血性心肌病和扩张型心肌病。

Abstract:

AIM To observe the long-term survival of patients with right ventricular pacing and to explore the risk factors that may affect the prognosis. METHODS A retrospective follow-up analysis was conducted in 1,245 patients implanted with permanent pacemaker from January 1991 to December 2010 for type II, degree II atrial-ventricular block, III degree atrial-ventricular block and auricular fibrillation with long interval and sick sinus syndrome such as slow cardiac arrhythmia. Follow-up data were continuously collected after pacemaker implantation until the endpoint. Survival rate was estimated using the Kaplan-Meier method and risk factors for mortality were sought using the multivariate Cox proportional hazards method. RESULTS The total survival rate during follow-up (3-23 years) was 91.3% and the survival rates at 5, 10, 15 and 20 years were, respectively, 92.9%, 88.9%, 81.9% and 75.1%. Single factor analysis showed that age, gender, pacemaker mode, chronic renal failure, ischemic cardiomyopathy and dilated cardiomyopathy (DCM) were the risk factors affecting the survival. Independent predictors of increased mortality were age at implant (hazard ratio, HR 1.987; 95% confidence interval, CI 1.587-2.489), DCM (HR 45.332; 95%CI 24.321-84.495) and ischemic cardiomyopathy (HR 8.418; 95%CI 3.605-19.65). CONCLUSION Implantation of permanent pacemaker prolongs the life of patients. Age at implant, ischemic cardiomyopathy and DCM are the independent risk factors for increased mortality.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2014-10-17.
通讯作者：汤宝鹏，教授，主要从事起搏电生理研究 Email：tangbaopeng@hotmail.com
作者简介：刘入源，副主任医师，硕士 Email：13579983921@163.com

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更新日期/Last Update: 2015-07-23