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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。
Objective To observe the survival of patients with long-term right ventricular pacing and the risk factors that may affect the prognosis by continuous follow-up pacemaker implantation. Methods From January 1991 to December 2010, patients with symptomatic bradyarrhythmia such as Class II degree II AV block, III degree atrioventricular block, atrial fibrillation with long gap, and sick sinus syndrome A total of 1 245 patients were enrolled in a permanent pacemaker. The follow-up was performed after the pacemaker was implanted to collect general information about the patient’s pacemaker implantation and the attendant illness. The Kaplan-Meier method was used to assess patient survival. Log Rank test was used to evaluate the risk factors of prognosis in patients with pacemaker implanted in the univariate analysis. Cox multivariate analysis was used to evaluate the independent risk factors affecting the prognosis. Results The overall survival rate was 91.3% at 3 to 23 years of follow-up. The 5-year survival rate, 10-year survival rate, 15-year survival rate and> 20-year survival rate were 92.9%, 88.7%, 81.9% and 75.1 %; Univariate analysis of risk factors affecting the survival and prognosis of patients with pacemakers are: age, gender, pacing mode, chronic renal failure, ischemic cardiomyopathy, dilated cardiomyopathy; Cox multivariate analysis, affecting pacemaker The independent risk factors for prognosis of patients implanted in the patients were age, ischemic cardiomyopathy and dilated cardiomyopathy. Conclusion The life span of patients with permanent pacemaker implantation is significantly prolonged. The independent risk factors affecting the prognosis of patients with pacemaker implantation are: age at implantation of pacemaker, ischemic cardiomyopathy and dilated cardiomyopathy.