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目的:观察糖尿病对植入永久人工心脏起搏器患者起搏参数及术后并发症的影响。方法:2008年6月~2011年6月80例植入永久人工心脏起搏器的病窦综合征患者,按是否有糖尿病分为糖尿病组(40例)和非糖尿病对照组(40例)。比较两组起搏器起搏参数及术后并发症。结果:基线时两组患者起搏器心房、心室起搏阈值,感知,阻抗差异均无显著性(P>0.05)。术后12月两组起搏器各参数均有不同程度增高;与非糖尿病组相比,糖尿病组心房、心室起搏阈值[心房:(0.59±0.23)V比(0.67±0.25)V,心室:(0.47±0.28)V比(0.54±0.35)V]、感知[心房:(2.33±1.16)mV比(2.92±1.36)mV,心室:(12.21±4.82)mV比(12.77±5.36)mV]、阻抗[心房:(537.12±115.32)Ω比(662.48±235.26)Ω,心室:(602.48±222.46)Ω比(762.41±235.38)Ω]增高更为明显(P<0.05或<0.01);术后并发症发生率糖尿病组明显高于非糖尿病组(12.5%比5%)。结论:合并糖尿病的病窦综合征心电重构较严重,植入永久人工心脏起搏器后并发症发生率明显升高。
Objective: To observe the effect of diabetes on pacing parameters and postoperative complications in patients with permanent artificial cardiac pacemaker. Methods: From June 2008 to June 2011, 80 patients with sick sinus syndrome with permanent artificial cardiac pacemaker were divided into diabetic group (40 cases) and non-diabetic control group (40 cases) according to their presence or absence of diabetes. The pacemaker pacing parameters and postoperative complications were compared between the two groups. Results: There was no significant difference in atrial pacing, ventricular pacing threshold, sensory and impedance between the two groups at baseline (P> 0.05). Compared with non-diabetic group, the parameters of atrial and ventricular pacing in the diabetic group [atrium: (0.59 ± 0.23) V vs (0.67 ± 0.25) V, (2.33 ± 1.16) mV vs (2.92 ± 1.36) mV and (12.21 ± 4.82) mV vs (12.77 ± 5.36) mV] (P <0.05 or <0.01), the impedance (atrium: (537.12 ± 115.32) Ω ratio (662.48 ± 235.26 Ω, ventricular: (602.48 ± 222.46) Ω ratio (762.41 ± 235.38) Ω] The complication rate was significantly higher in the diabetic group than in the non-diabetic group (12.5% vs. 5%). Conclusion: The electrocardiographic remodeling of sick sinus syndrome with diabetes mellitus is more serious. The incidence of complication after permanent artificial cardiac pacemaker implantation is obviously increased.