中华心血管杂志CHINESEJOURNALOFCARDIOLOGY第26卷第5期1998年10月28日出版科技期刊*临床研究*病窦综合征转为持续性心房颤动对运动耐量和生活质量的影响王兵黄德嘉陈小鸥唐炯【摘要】目的探讨心房颤动（房颤）病人在较好控制心室率后，房颤本身对运动耐量和生活质量有何影响。方法选择无其它器质性心脏病证据的病态窦房结综合征患者，在安置VVI型心脏起搏器后，以无房颤的15例为对照，比较其与发生慢性房颤后较好控制心室率的15例患者在运动耐量和生活质量方面有无差异。结果房颤组的基础心率、第一级运动后心率和最大心率均显著高于对照组（82.75±16.72和63.07±6.42次/分,P<0.01；114.08±12.03和82.67±12.03次/分,P<0.01;152.17±42.32和96.25±18.49次/分,P<0.01)。两组的运动持续时间和代谢当量相近（15.10±2.92和15.78±2.53min,P>0.05;8.08±1.73和8.25±1.22MET,P>0.05)。房颤组和对照组的生活质量各维度评分相比，差异无显著性。躯体功能维度为36.58±2.84和36.83±2.86,P>0.05；因躯体功能所致角色限制为8.08±2.38和7.17±1.53,P>0.05；因情感问题所致角色限制为7.17±1.08和7.6±1.61，P>0.05；社会功能为17.67±2.53和18.17±7.89，P>0.05；完好状态主观感觉为52.75±6.03和52.83±9.58，P>0.05；症状为15.08±1.73和15.58±2.39，P>0.05。结论房颤组和对照组的运动耐量和生活质量相近，从这个意义上来讲，对这一特定类型的慢性房颤患者似无必要转复为窦律，房颤对这类病人远期预后的影响尚需进一步研究。【关键词】心房颤动病窦综合征心脏起搏，人工生活质量EffectofchronicatrialfibrillationonexercisetoleranceandqualityoflifeinpacedpatientswithsicksinussyndromeWangBing,HuangDejia,ChenXiaoou,etal.FirstAffiliatedHospital,WestChinaUniversityofMedicalSciences,Chengdu610041【Abstract】ObjectiveItisstillunknownifheartrateiscontrolledwellhowchronicatrialfibrillation(CAF)itselfinfluencesexercisetoleranceandqualityoflife.MethodsAfterVVIpacemakerimplanted,15withCAFisolatedsicksinussyndrome(SSS)patientsand15sex,ageandheart1functionalclassmatchedwithoutCAFisolatedSSSpatientswereselected.RestheartrateofCAFpatientswasbelow90beats/minute(bpm)afterdigoxin(0.125mgoncedaily),ordigoxin(0.125mgoncedaily)andmetoprolol(12.5mgtwicedaily),ordigoxin(0.125mgoncedaily)anddiltiazem(30mgthreetimesdaily)administrated.AllthesepatientstooktreadmillexercisetestingandfinishedmodifiedSF-50questionnaire.ResultsThelevelsofrestheartrateafterfirststageandmaximalheartrateofCAFgroupweresignificantlyhigherthancontrolgroup(82.75±16.72vs63.17±6.24bpm.P<0.01;114.08±30.42vs82.67±12.03bpm.P<0.01;152.17±42.32vs96.75±18.49bpm,P<0.01).TherewerenosignificantdifferencesbetweenCAFgroupandcontrolgroupinexercisetime(15.10±2.92vs15.78±2.53minute,P>0.05)andMET(8.08±1.73vs8.25±1.22P>0.05).ScoresofeachdimentionofmodifiedSF-50inCAFgroupweresimilartocontrolgroup(physicalfunctioning36.58±2.84vs36.83±2.86,P>0.05;role-physical8.08±1.38vs8.17±1.53,P>0.05;role-emotional7.17±2.08vs7.67±1.61,P>0.05;socialfunctioning17.67±2.53vs18.17±2.89,P>0.05;generalwell-beingperceptions52.75±6.03vs52.83±9.58,P>0.05;symptoms15.08±1.73vs15.58±2.39,P>0.05).ConclusionTherewerenosignificantdifferencesbetweenCAFgroupandcontrolgroupinexercisetoleranceandqualityoflife.Inthissense,itissuggestedthatthereisnonecessaryforthecertaintypeofCAFtoberestoredtosinusrhythm.TheinfluenceofCAFontheprognosisofthesepatientsneedsfurthurstudies.【Keywords】atrialfibrillationsicksinussyndromecardiacpacing,artificialqualityoflife病态窦房结综合征（简称病窦）是临床常见的心律失常，安置心脏起搏器后部分患者可出现慢性心房颤动（简称房颤）。发生慢性房颤后，常用的治...