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(\u4e8c)\u5c04\u8840\u5206\u6570\u4fdd\u7559\u5fc3\u8870\u60a3\u8005\u884c\u9891\u7387\u9002\u5e94\u6027\u5fc3\u623f\u8d77\u640f\u6cbb\u7597\uff1aRAPID-HF\u968f\u673a\u4e34\u5e8a\u7814\u7a76[9]<\/sup><\/p>\n

\u9891\u7387\u9002\u5e94\u6027\u8d77\u640f\u662f\u751f\u7406\u6027\u8d77\u640f\u7684\u91cc\u7a0b\u7891\u4e4b\u4e00\u3002\u8d77\u640f\u5668\u901a\u8fc7\u4f20\u611f\u5668\u611f\u77e5\u8eaf\u4f53\u8fd0\u52a8\u6216\u4ee3\u8c22\u7684\u53d8\u5316\u4fe1\u53f7\uff0c\u5c06\u5176\u8f6c\u53d8\u4e3a\u8d77\u640f\u9891\u7387\u7684\u6539\u53d8\uff0c\u4ee5\u6ee1\u8db3\u5fc3\u810f\u53d8\u65f6\u529f\u80fd\u4e0d\u5168\u60a3\u8005\u5728\u4e0d\u540c\u72b6\u6001\u4e0b\u7684\u5fc3\u6392\u91cf\u9700\u6c42\uff0c\u4ece\u800c\u63d0\u9ad8\u60a3\u8005\u7684\u6d3b\u52a8\u8010\u91cf\u548c\u751f\u6d3b\u8d28\u91cf\u3002\u65e2\u5f80\u7814\u7a76\u8ba4\u4e3a\uff0c\u5fc3\u810f\u53d8\u65f6\u529f\u80fd\u4e0d\u5168\u53ef\u80fd\u662f\u5bfc\u81f4\u5c04\u8840\u5206\u6570\u4fdd\u7559\u578b\u5fc3\u529b\u8870\u7aed\uff08HFpEF\uff09\u60a3\u8005\u8fd0\u52a8\u529f\u80fd\u53d7\u9650\u7684\u4e00\u79cd\u673a\u5236\u3002\u4e00\u534a\u4ee5\u4e0a\u7684HFpEF\u60a3\u8005\u5b58\u5728\u7740\u660e\u663e\u7684\u53d8\u65f6\u529f\u80fd\u4e0d\u5168\u3002RAPID-HF\u7814\u7a76\u662f\u4e00\u9879\u5355\u4e2d\u5fc3\u3001\u53cc\u76f2\u7684\u5c0f\u578b\u968f\u673a\u4ea4\u53c9\u8bd5\u9a8c\u3002\u7814\u7a76\u9891\u7387\u9002\u5e94\u6027\u8d77\u640f\u5bf9HFpEF\u60a3\u8005\u8fd0\u52a8\u80fd\u529b\u5e26\u6765\u7684\u5f71\u54cd\u3002\u5176\u7eb3\u5165\u6807\u51c6\u5305\u62ec\uff1aLVEF\u226540%\uff0c\u7aa6\u6027\u5fc3\u5f8b\uff0c\u5fc3\u529f\u80fd\u2161\uff5e\u2162\u7ea7\uff08NYHA\u5206\u7ea7\uff09\uff0c\u7b26\u5408\u5fc3\u529b\u8870\u7aed\u548c\u53d8\u65f6\u6027\u529f\u80fd\u4e0d\u5168\u7684\u5ba2\u89c2\u6807\u51c6\uff0c\u690d\u5165\u53cc\u8154\u8d77\u640f\u5668\u3002\u8d77\u640f\u5668\u7ba1\u7406\uff1a\u8d77\u640f\u5f00\u542f\u6a21\u5f0f\uff08AAI-R\uff0c\u901f\u7387\u4e0b\u9650\u4e3a30\u6b21\/min\uff0c\u6d3b\u52a8\u65f6\u53cc\u659c\u5761\u901f\u7387\u54cd\u5e94\uff0c\u5feb\u8d70\u65f6\u76ee\u6807\u5fc3\u7387\u4e3a100~110\u6b21\/min\uff09\u6216\u8d77\u640f\u5173\u95ed\u6a21\u5f0f\uff08VVI\u4e3a30\u6b21\/min\uff0c\u6d3b\u52a8\u65f6\u4e0d\u8fdb\u884c\u8d77\u640f\uff0c\u5728\u610f\u5916\u7684\u7f13\u6162\u6027\u5fc3\u5f8b\u5931\u5e38\u65f6\u4ec5\u8fdb\u884c\u5907\u7528\u8d77\u640f\uff09\u3002\u4e3b\u8981\u7ec8\u70b9\u662f\u65e0\u6c27\u9608\u503cVO2<\/sub>\uff08VO2<\/sub>, AT<\/sub>\uff09\u7684\u53d8\u5316\u3002\u6b21\u8981\u7ec8\u70b9\u662f\u5cf0\u503c\u6c27\u8017\u91cf\uff08\u5cf0\u503cVO2<\/sub>\uff09\uff0c\u582a\u8428\u65af\u57ce\u5fc3\u808c\u75c5\u8c03\u67e5\u95ee\u5377\u6c47\u603b\u8bc4\u5206\uff08KCCQ-OSS\uff09\u548c\u8840NT-pro BNP\u6c34\u5e73\u3002\u7814\u7a76\u5171\u5165\u9009\u4e8632\u4f8b\u60a3\u8005\uff0c\u5176\u4e2d29\u4f8b\u690d\u5165\u4e86\u53cc\u8154\u8d77\u640f\u5668\uff0c\u5e73\u5747\u5e74\u9f8466\u5c81\u3002\u60a3\u8005\u968f\u673a\u5206\u4e3a\u4e24\u7ec4\uff0c\u5171\u8fdb\u884c12\u5468\u8bd5\u9a8c\u3002\u5728\u7814\u7a76\u5f00\u59cb\u7684\u524d4\u5468\u968f\u673a\u8fdb\u884c\u9891\u7387\u9002\u5e94\u6027\u8d77\u640f\u6216\u4e0d\u8d77\u535a\uff0c\u63a5\u4e0b\u6765\u8fdb\u51654\u5468\u7684\u6d17\u8131\u671f\uff0c\u6700\u540e4\u5468\u4ea4\u53c9\u66f4\u6362\u4e3a\u53e6\u4e00\u79cd\u5e72\u9884\u63aa\u65bd\u3002\u7ed3\u679c\u663e\u793a\uff0c\u5728\u4e0d\u8d77\u640f\u7684\u60c5\u51b5\u4e0b\uff0cVO2<\/sub>\u3001VO2<\/sub>\uff0cAT<\/sub>\u5747\u4e0e\u8fd0\u52a8\u65f6\u5cf0\u503c\u5fc3\u7387\u76f8\u5173\uff08r=0.46~0.51\uff0c\u5747P\uff1c0.05\uff09\u3002\u8d77\u640f\u63d0\u5347\u4e86\u60a3\u8005\u5728\u4f4e\u5f3a\u5ea6\u548c\u5cf0\u503c\u8fd0\u52a8\u671f\u95f4\u7684\u5fc3\u7387\uff08P\uff1c0.01\uff09\uff0c\u4f46\u4e0d\u8d77\u640f\u548c\u8d77\u640f\u7ec4\u4e4b\u95f4\u7684VO2<\/sub>\uff0cAT<\/sub>\uff0cVO2<\/sub>\u3001KCCQ-OSS\u548cNT-pro BNP\u6c34\u5e73\u6bd4\u8f83\uff0c\u5dee\u5f02\u5747\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P\uff1e0.05\uff09\u3002\u8be5\u7814\u7a76\u7ed3\u679c\u8868\u660e\u9891\u7387\u9002\u5e94\u6027\u8d77\u640f\u5668\u7684\u690d\u5165\u4e5f\u8bb8\u5e76\u4e0d\u80fd\u7ed9\u5408\u5e76\u6709\u53d8\u65f6\u529f\u80fd\u4e0d\u5168\u7684HFpEF\u60a3\u8005\u5e26\u6765\u4e34\u5e8a\u83b7\u76ca\u3002<\/p>\n

(\u4e09)\u4e2a\u4f53\u5316\u52a0\u901f\u8d77\u640f\u5bf9\u4e34\u5e8a\u524d\u548c\u5c04\u8840\u5206\u6570\u4fdd\u7559\u7684\u5fc3\u529b\u8870\u7aed\u60a3\u8005\u7684\u751f\u6d3b\u8d28\u91cf\u3001\u6d3b\u52a8\u8010\u91cf\u548c\u5fc3\u623f\u98a4\u52a8\u7684\u5f71\u54cd\u2014\u2014The myPACE\u7814\u7a76[10]<\/sup><\/p>\n

The myPACE\u7814\u7a76\u662f\u4e00\u9879\u524d\u77bb\u6027\u3001\u76f2\u6cd5\u3001\u5e73\u884c\u7ec4\u3001\u968f\u673a\u4e34\u5e8a\u8bd5\u9a8c\u3002\u7eb3\u5165B\u671f\u548cC\u671f\u7684HFpEF\u60a3\u8005\uff08EF\uff1e50%\uff09\u3002\u6392\u9664\u6807\u51c6\u662f\u8d77\u640fQRS\u65f6\u9650\u2265150ms\u3002myPACE\u7684\u4e2a\u6027\u5316\u52a0\u901f\u5fc3\u7387\u662f\u6839\u636e\u5065\u5eb7\u6210\u4eba\u7684\u8eab\u9ad8\u548c\u5c04\u8840\u5206\u6570\u8ba1\u7b97\u7684\u3002\u5165\u9009\u53c2\u4e0e\u8005\u5b8c\u6210\u57fa\u7ebf\u8bc4\u4f30\u540e\u4ee51\u22361\u7684\u6bd4\u4f8b\u968f\u673a\u5206\u914d\u5230\u4e2a\u6027\u5316\u52a0\u901f\u8d77\u640f\u7ec4\uff08n=48\uff0cmyPACE\uff09\u6216\u5e38\u89c4\u6cbb\u7597\u7ec4\uff08n=52\uff0c60\u6b21\/min\uff09\u3002\u4e3b\u8981\u7ec8\u70b9\u662f\u660e\u5c3c\u82cf\u8fbe\u5fc3\u529b\u8870\u7aed\u751f\u6d3b\u95ee\u5377\uff08MLHFQ\uff09\u8bc4\u5206\u76f8\u8f83\u4e8e\u57fa\u7ebf\u7684\u53d8\u5316\u3002\u6b21\u8981\u7ec8\u70b9\u5305\u62ecNT-pro BNP\u6c34\u5e73\u7684\u53d8\u5316\uff0c\u8d77\u640f\u5668\u68c0\u6d4b\u5230\u7684\u6d3b\u52a8\u8010\u91cf\u3001\u623f\u98a4\u548c\u4e34\u5e8a\u7ed3\u5c40\u3002\u5e73\u5747\uff08SD\uff09\u968f\u8bbf\u65f6\u95f4\u4e3a378\uff0883\uff09\u5929\uff0c\u4e0e\u57fa\u7ebf\u76f8\u6bd4\uff0c\u5e38\u89c4\u6cbb\u7597\u7ec4\u7684\u5e73\u5747\uff08SD\uff09MLHFQ\u5f97\u5206\u57281\u4e2a\u6708\u65f6\u4e0b\u964d0.6\uff089.1\uff09\u5206\uff0c\u57281\u5e74\u65f6\u4e0a\u5347\uff08\u6076\u5316\uff093.5\uff0810.6\uff09\u5206\u3002\u4e2a\u6027\u5316\u52a0\u901f\u8d77\u640f\u7ec4\u57281\u4e2a\u6708\u548c1\u5e74\u65f6\u7684MLHFQ\u5f97\u5206\u5e73\u5747\uff08SD\uff09\u5206\u522b\u4e0b\u964d\u4e8610.9\uff0813.7\uff09\u548c15.0\uff0815.5\uff09\u5206\u3002\u7ec4\u95f4\u6bd4\u8f83\u8868\u660e\uff0c\u4e0e\u5e38\u89c4\u6cbb\u7597\u7ec4\u76f8\u6bd4\uff0c\u4e2a\u6027\u5316\u52a0\u901f\u8d77\u640f\u7ec4\u5728\u57fa\u7ebf\u65f6\u7684MLHFQ\u5f97\u5206\u76f8\u4f3c\uff0c\u800c\u57281\u4e2a\u6708\u548c1\u5e74\u7684\u968f\u8bbf\u4e2d\uff0cMLHFQ\u5f97\u5206\u66f4\u597d\u3002\u6b21\u8981\u7ec8\u70b9\u65b9\u9762\uff0c\u4e0e\u5e38\u89c4\u6cbb\u7597\u7ec4\u76f8\u6bd4\uff0c\u5728\u8be5\u4eba\u7fa4\u4e2d\u4ee5\u9002\u5ea6\u52a0\u901f\u7684\u4e2a\u6027\u5316\u5907\u7528\u9891\u7387\u8d77\u640f\u4e5f\u6539\u5584\u4e86NT-pro BNP\u6c34\u5e73\u3001\u6d3b\u52a8\u8010\u91cf\u548c\u623f\u98a4\u7684\u53d1\u4f5c\u3002myPACE\u7814\u7a76\u652f\u6301\u5fc3\u7387\u8c03\u8282\u4f5c\u4e3aHFpEF\u60a3\u8005\u7684\u6cbb\u7597\u63aa\u65bd\uff0c\u8868\u660e\u9002\u5ea6\u63d0\u9ad8\u5fc3\u7387\u5bf9\u8fd9\u79cd\u590d\u6742\u7684\u60a3\u8005\u4eba\u7fa4\u662f\u6709\u76ca\u7684\u3002<\/p>\n

(\u56db)\u8bbe\u5907\u68c0\u6d4b\u7684\u4e9a\u4e34\u5e8a\u623f\u98a4\uff08\u5fc3\u623f\u9ad8\u9891\u4e8b\u4ef6\uff09\u6297\u51dd\uff1a\u5352\u4e2d\u4e0e\u51fa\u8840\u98ce\u9669\u7684\u53cc\u5203\u5251[11-13]<\/sup><\/p>\n

\u8fd1\u671f\u300a\u65b0\u82f1\u683c\u5170\u533b\u5b66\u6742\u5fd7\u300b\u53d1\u8868\u7684NOAH-AFNET 6\u548cARTESiA\u8bd5\u9a8c\u5206\u522b\u6bd4\u8f83\u4e86\u827e\u591a\u6c99\u73ed\u548c\u963f\u54cc\u6c99\u73ed\u5bf9\u4e9a\u4e34\u5e8a\u623f\u98a4\u60a3\u8005\u51cf\u5c11\u6813\u585e\u4e8b\u4ef6\u7684\u5f71\u54cd[12, 13]<\/sup>\u3002\u5176\u4e2dNOAH-AFNET 6\u51fa\u4e8e\u5b89\u5168\u8003\u8651\u548c\u65e0\u6548\u6027\u8d8b\u52bf\u63d0\u524d\u7ec8\u6b62\uff0c\u7ed3\u679c\u663e\u793a\u827e\u591a\u6c99\u73ed\u6297\u51dd\u7ec4\u4e0e\u5b89\u6170\u5242\u7ec4\u7684\u5352\u4e2d\u3001\u7cfb\u7edf\u6027\u6813\u585e\u6216\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u7684\u4e3b\u8981\u590d\u5408\u7ec8\u70b9\u65e0\u663e\u8457\u5dee\u5f02[12]<\/sup>\u3002\u800cARTESiA\u8bd5\u9a8c\u5219\u8bc1\u660e\u963f\u54cc\u6c99\u73ed\u663e\u8457\u964d\u4f4e\u4e86\u7f3a\u8840\u6027\u5352\u4e2d\u6216\u7cfb\u7edf\u6027\u6813\u585e\u7684\u4e3b\u8981\u590d\u5408\u7ec8\u70b9\u3002\u8be5\u7c7b\u60a3\u8005\u7684\u6297\u51dd\u95ee\u9898\u4f3c\u4e4e\u4ecd\u4e0d\u660e\u786e[13]<\/sup>\u3002\u8fd1\u671fCirculation\u6742\u5fd7\u4e0a\u53d1\u8868\u4e86\u4e00\u9879NOAH-AFNET 6\u548cARTESiA\u8bd5\u9a8c\u7684\u835f\u8403\u5206\u6790\uff0c\u5bf9\u4e0a\u8ff0\u4e24\u9879\u8bd5\u9a8c\u7684\u7ed3\u679c\u8fdb\u884c\u4e86\u7efc\u5408\u5206\u6790\uff0c\u4ece\u800c\u63a2\u7a76\u4e86\u4e9a\u4e34\u5e8a\u623f\u98a4\u6297\u51dd\u7684\u5352\u4e2d\u4e0e\u51fa\u8840\u98ce\u9669[11]<\/sup>\u3002\u4ece785\u4e2a\u7814\u7a76\u4e2d\uff0c\u5171\u7b5b\u9009\u51fa\u4e862\u9879\u7b26\u5408\u6807\u51c6\u7684\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff1aNOAH-AFNET 6\u8bd5\u9a8c\uff08\u51712536\u540d\u53c2\u4e0e\u8005\uff09\u548cARTESiA\u8bd5\u9a8c\uff08\u51714012\u540d\u53c2\u4e0e\u8005\uff09\u3002\u4e3b\u8981\u7ec8\u70b9\u65b9\u9762\uff0cNOAH-AFNET 6\u8bd5\u9a8c\u7684\u6297\u51dd\u7ec4\u4e0e\u5bf9\u7167\u7ec4\u7684\u7f3a\u8840\u6027\u5352\u4e2d\u5e74\u53d1\u75c5\u7387\u5206\u522b\u4e3a0.9%\u548c1.1%\uff0c\u800cARTESiA\u8bd5\u9a8c\u7684\u6297\u51dd\u7ec4\u4e0e\u5bf9\u7167\u7ec4\u7684\u7f3a\u8840\u6027\u5352\u4e2d\u5e74\u53d1\u75c5\u7387\u5206\u522b\u4e3a0.6%\u548c1.0%\u3002\u835f\u8403\u5206\u6790\u7ed3\u679c\u8868\u660e\u76f8\u8f83\u4e8e\u6297\u8840\u5c0f\u677f\u836f\u7269\u6216\u5b89\u6170\u5242\uff0c\u53e3\u670d\u6297\u51dd\u53ef\u6709\u6548\u51cf\u5c11\u4e9a\u4e34\u5e8a\u623f\u98a4\u7684\u7f3a\u8840\u6027\u5352\u4e2d\u53d1\u75c5\uff08RR 0.68, 95% CI 0.5~0.92, I2<\/sup>=0%\uff09\uff08\u8be5\u7ed3\u8bba\u7684\u7814\u7a76\u8bc1\u636e\u7ea7\u522b\u9ad8\uff0c\u504f\u501a\u8f83\u5c0f\uff09\u3002\u6b21\u8981\u7597\u6548\u7ec8\u70b9\u65b9\u9762\uff0c\u4e24\u9879\u8bd5\u9a8c\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u8868\u660e\u53e3\u670d\u6297\u51dd\u836f\u663e\u8457\u51cf\u5c11\u7f3a\u8840\u6027\u5352\u4e2d\u6216\u7cfb\u7edf\u6027\u6813\u585e\u4e8b\u4ef6\uff08RR 0.63, 95% CI 0.47~0.84, I2<\/sup>=0%\uff09\uff08\u8bc1\u636e\u7ea7\u522b\u9ad8\uff09\u3001\u5168\u56e0\u5352\u4e2d\u3001\u5916\u5468\u52a8\u8109\u6813\u585e\u3001\u5fc3\u808c\u6897\u6b7b\u3001\u80ba\u52a8\u8109\u6813\u585e\u6216\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u7684\u590d\u5408\u7ec8\u70b9\uff08RR 0.85, 95% CI 0.73~0.99, I2<\/sup>=0%\uff09\uff08\u7814\u7a76\u7ea7\u522b\u4e2d\u7b49\uff09\u3001\u5168\u56e0\u5352\u4e2d\u6216\u7cfb\u7edf\u6027\u6813\u585e\u7684\u590d\u5408\u7ec8\u70b9\uff08RR 0.65, 95% CI 0.49~0.86, I2<\/sup>=0%\uff09\uff08\u8bc1\u636e\u7ea7\u522b\u9ad8\uff09\u3002\u6b64\u5916\uff0c\u53e3\u670d\u6297\u51dd\u836f\u672a\u663e\u8457\u51cf\u5c11\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u548c\u5168\u56e0\u6b7b\u4ea1\u4e8b\u4ef6\uff08\u7814\u7a76\u7ea7\u522b\u4e2d\u7b49\uff09\u3002\u5b89\u5168\u6027\u7ec8\u70b9\u65b9\u9762\uff0cNOAH-AFNET 6\u8bd5\u9a8c\u7684\u6297\u51dd\u7ec4\u4e0e\u5bf9\u7167\u7ec4\u7684\u5927\u51fa\u8840\u5e74\u53d1\u75c5\u7387\u5206\u522b\u4e3a1.7%\u548c1.0%\uff0c\u800cARTESiA\u8bd5\u9a8c\u7684\u6297\u51dd\u7ec4\u4e0e\u5bf9\u7167\u7ec4\u7684\u5927\u51fa\u8840\u5e74\u53d1\u75c5\u7387\u5206\u522b\u4e3a1.5%\u548c1.1%\u3002\u835f\u8403\u5206\u6790\u7ed3\u679c\u8868\u660e\u76f8\u8f83\u4e8e\u6297\u8840\u5c0f\u677f\u836f\u6216\u5b89\u6170\u5242\uff0c\u53e3\u670d\u6297\u51dd\u836f\u663e\u8457\u589e\u52a0\u4e9a\u4e34\u5e8a\u623f\u98a4\u7684\u5927\u51fa\u8840\u4e8b\u4ef6\uff08RR 1.62, 95% CI 1.05~2.5, I2<\/sup>=61%\uff09\u3002\u8be5\u7ed3\u8bba\u7684\u7814\u7a76\u8bc1\u636e\u7ea7\u522b\u9ad8\uff0c\u504f\u501a\u8f83\u5c0f\u3002\u6b64\u5916\uff0c\u53e3\u670d\u6297\u51dd\u836f\u663e\u8457\u589e\u52a0\u5168\u56e0\u6b7b\u4ea1\u6216\u5927\u51fa\u8840\u7684\u590d\u5408\u7ec8\u70b9\uff08RR 1.16, 95% CI 1.0~1.35, I2<\/sup>=35%\uff09\uff08\u8bc1\u636e\u7ea7\u522b\u4e2d\u7b49\uff09\uff0c\u800c\u672a\u663e\u8457\u589e\u52a0\u81f4\u547d\u6027\u51fa\u8840\u4e8b\u4ef6\uff08RR 0.79, 95% CI 0.37~1.69, I2<\/sup>=0%\uff09\uff08\u8bc1\u636e\u7ea7\u522b\u9ad8\uff09\u3002\u56e0\u6b64\uff0c\u8be5\u9879\u835f\u8403\u5206\u6790\u7ed3\u679c\u8868\u660e\uff0c\u4e9a\u4e34\u5e8a\u623f\u98a4\u60a3\u8005\u63a5\u53d7\u6297\u51dd\u6cbb\u7597\uff0c\u7f3a\u8840\u6027\u5352\u4e2d\u4e8b\u4ef6\u51cf\u5c11\u7ea6\u4e09\u5206\u4e4b\u4e00\uff0c\u800c\u5927\u51fa\u8840\u98ce\u9669\u589e\u52a0\u7ea6\u4e24\u500d\uff0c\u4e3a\u76ee\u524d\u6700\u9ad8\u7684\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u3002<\/p>\n

(\u4e94)\u8840\u7ba1\u5185\u51b2\u51fb\u6ce2\u6cbb\u7597\u5728\u7ecf\u9759\u8109\u8d77\u640f\u7535\u6781\u62d4\u9664\u4e2d\u7684\u5e94\u7528[14]<\/sup><\/p>\n

\u968f\u7740\u690d\u5165\u5bfc\u7ebf\u7684\u65f6\u95f4\u5ef6\u957f\u8d77\u640f\u5bfc\u7ebf\u5468\u56f4\u51fa\u73b0\u81f4\u5bc6\u9499\u5316\uff0c\u8fd9\u589e\u52a0\u4e86\u7ecf\u9759\u8109\u7535\u6781\u5bfc\u7ebf\u62d4\u51fa\u672f\u7684\u96be\u5ea6\u548c\u98ce\u9669\u3002\u51b2\u51fb\u6ce2\u8840\u7ba1\u5185\u788e\u77f3\u672f\uff08IVL\uff09\u53ef\u5229\u7528\u58f0\u6ce2\u88c2\u89e3\u5bfc\u7ba1\u5468\u56f4\u7684\u9499\u5316\u7ec4\u7ec7\u3002Latanich \u7b49\u8bc4\u4f30\u4e86\u51b2\u51fb\u6ce2\u8840\u7ba1\u5185\u788e\u77f3\u672f\u9884\u5904\u7406\u5bf9\u62d4\u9664\u690d\u5165\u65f6\u95f4\u8f83\u957f\u7684\u8d77\u640f\u5668\u7535\u6781\u6216\u9664\u98a4\u5668\u7535\u6781\u7684\u5f71\u54cd\u3002\u56de\u987e\u6027\u7814\u7a762019\u5e7410\u6708\u81f32023\u5e744\u6708\u5728\u660e\u5c3c\u82cf\u8fbe\u5dde\u5fb7\u5362\u65af\u7684Essentia Health\u63a5\u53d7\u7535\u6781\u5bfc\u7ebf\u62d4\u9664\u6cbb\u7597\u7684\u60a3\u8005\u6570\u636e\u3002\u51b2\u51fb\u6ce2\u8840\u7ba1\u5185\u788e\u77f3\u672f\u9884\u5904\u7406\u91c7\u75287mm\u548c8mm\u51b2\u51fb\u6ce2\u7403\u56ca\uff0c\u8d34\u8fd1\u7535\u6781\u9499\u5316\u7ec4\u7ec7\u8fdb\u884c\u51b2\u51fb\u6ce2\u6cbb\u7597\u3002\u5728120\u4f8b\u63a5\u53d7\u624b\u672f\u7684\u60a3\u8005\u4e2d\uff0c55\u4f8b\u56e0\u7535\u6781\u53ef\u5e38\u89c4\u62d4\u9664\u800c\u88ab\u6392\u9664\u5728\u7814\u7a76\u4e4b\u5916\u3002\u5176\u4f5965\u4f8b\u60a3\u8005\uff0c14\u4f8b\u63a5\u53d7\u51b2\u51fb\u6ce2\u8840\u7ba1\u5185\u788e\u77f3\u672f\u9884\u5904\u7406\u3002\u60a3\u8005\u4e2d\u4f4d\u5e74\u9f84\u4e3a67\u5c81\uff0c\u4e2d\u4f4d\u5bfc\u7ebf\u690d\u5165\u65f6\u95f4\u4e3a10.7\u5e74\u3002\u51b2\u51fb\u6ce2\u8840\u7ba1\u5185\u788e\u77f3\u672f\u9884\u5904\u7406\u7ec4\u4e0e\u5e38\u89c4\u7ec4\u7cd6\u5c3f\u75c5\u3001\u5352\u4e2d\u3001\u65e2\u5f80\u80f8\u9aa8\u5207\u5f00\u672f\u548c\u7535\u6781\u5bfc\u7ebf\u7c7b\u578b\u65e0\u663e\u8457\u5dee\u5f02\u3002\u51b2\u51fb\u6ce2\u8840\u7ba1\u5185\u788e\u77f3\u672f\u9884\u5904\u7406\u53ef\u5e73\u5747\u7f29\u77ed\u7535\u6781\u5bfc\u7ebf\u62d4\u9664\u65f6\u95f4\u7ea625min\uff08IQR\uff1a9~42\uff0cP=0.007\uff09\u3002\u8be5\u7814\u7a76\u9996\u6b21\u660e\u786e\u51b2\u51fb\u6ce2\u8840\u7ba1\u5185\u788e\u77f3\u672f\u9884\u5904\u7406\u5728\u62d4\u9664\u9ad8\u98ce\u9669\u548c\u590d\u6742\u75c5\u53d8\u7535\u6781\u4e2d\u7684\u5e94\u7528\uff0c\u5e76\u53ef\u663e\u8457\u51cf\u5c11\u9ad8\u98ce\u9669\u624b\u672f\u65f6\u95f4\u3002<\/p>\n

(\u516d)\u75c7\u72b6\u6027\u690d\u5165\u5fc3\u8840\u7ba1\u690d\u5165\u578b\u7535\u5b50\u5668\u68b0\u7535\u6781\u5bfc\u7ebf\u6240\u81f4\u7684\u9759\u8109\u963b\u585e\u7684\u53d1\u751f\u7387\u3001\u6cbb\u7597\u548c\u7ed3\u5c40[15]<\/sup><\/p>\n

2023\u5e746\u6708\u7f8e\u56fd\u5fc3\u810f\u75c5\u5b66\u4f1a\u6742\u5fd7\uff08JACC\uff09\u53d1\u8868\u4e86\u4e00\u9879\u7814\u7a76\uff0c\u63a2\u8ba8\u4e86\u690d\u5165\u5fc3\u8840\u7ba1\u690d\u5165\u578b\u7535\u5b50\u5668\u68b0\uff08CIED\uff09\u540e\u75c7\u72b6\u6027\u5bfc\u7ebf\u76f8\u5173\u7684\u9759\u8109\u963b\u585e\uff08LRVO\uff09\u7684\u53d1\u75c5\u7387\u3002\u7814\u7a76\u57282015\u5e7410\u6708\uff5e2020\u5e7412\u6708\u5171\u7eb3\u5165\u8fd165\u4e07\u4f8b\u690d\u5165CIED\u7684\u60a3\u8005\u3002\u7ed3\u679c\u663e\u793a\uff0c28 214\u4f8b\u60a3\u8005\u53d1\u751fLRVO\uff0c\u5728\u6700\u957f5.2\u5e74\u7684\u968f\u8bbf\u4e2d\uff0c\u7d2f\u79ef\u53d1\u751f\u7387\u4e3a5.0%\u3002LRVO\u7684\u72ec\u7acb\u9884\u6d4b\u56e0\u7d20\u5305\u62ec\u6162\u6027\u80be\u810f\u75c5\uff08HR\uff1d1.17\uff09\u3001CIED\u5bfc\u7ebf\uff1e1\u6839\uff08HR\uff1d1.09\uff09\u548c\u6076\u6027\u80bf\u7624\uff08HR\uff1d1.23\uff09\u3002\u5927\u591a\u6570LRVO\u60a3\u8005\uff0885.2\uff05\uff09\u63a5\u53d7\u4e86\u4fdd\u5b88\u6cbb\u7597\u3002\u5728\u63a5\u53d7\u5e72\u9884\u76844186\u4f8b\uff0814.8\uff05\uff09\u60a3\u8005\u4e2d\uff0c74.0\uff05\u63a5\u53d7CIED\u7535\u6781\u5bfc\u7ebf\u62d4\u9664\u672f\uff0c26.0\uff05\u63a5\u53d7\u7ecf\u76ae\u8840\u8fd0\u91cd\u5efa\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c90\uff05\u7684\u60a3\u8005\u5728\u62d4\u9664\u7535\u6781\u5bfc\u7ebf\u540e\u6ca1\u6709\u518d\u63a5\u53d7CIED\u690d\u5165\uff0c\u65e0\u5bfc\u7ebf\u8d77\u640f\u5668\u7684\u4f7f\u7528\u7387\u8f83\u4f4e\uff082.2\uff05\uff09\u3002\u6821\u6b63\u540e\u7684\u6a21\u578b\u663e\u793a\uff0c\u4e0e\u4fdd\u5b88\u6cbb\u7597\u76f8\u6bd4\uff0c\u62d4\u9664\u7535\u6781\u5bfc\u7ebf\u4e0eLRVO\u76f8\u5173\u7684\u533b\u7597\u670d\u52a1\u663e\u8457\u51cf\u5c11\u76f8\u5173\uff08RR\uff1d0.58\uff09\u3002<\/p>\n

                                                         \u4f5c\u8005\uff1a\u8d75\u723d \u674e\u6653\u7476 \u674e\u6653\u67ab \u674e\u82e5\u8c37 \u9648\u6837\u65b0<\/p>\n

\u53c2\u8003\u6587\u732e<\/p>\n

[1]\u5f20\u6f8d, \u738b\u65b9\u6b63, \u9ec4\u5fb7\u5609,\u7b49. \u690d\u5165\u6027\u5fc3\u810f\u8d77\u640f\u5668\u6cbb\u7597–\u76ee\u524d\u8ba4\u8bc6\u548c\u5efa\u8bae[J]. \u4e2d\u534e\u5fc3\u5f8b\u5931\u5e38\u5b66\u6742\u5fd7, 2003, 7(1): 8-21.<\/p>\n

[2] EPSTEIN AE, DIMARCO JP, ELLENBOGEN KA, et al. ACC\/AHA\/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC\/AHA\/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons[J]. J Am Coll Cardiol, 2008,51(21):e1-e62.<\/p>\n

[3] \u5f20\u6f8d, \u534e\u4f1f, \u9ec4\u5fb7\u5609,\u7b49. \u690d\u5165\u6027\u5fc3\u810f\u8d77\u640f\u5668\u6cbb\u7597\u2014\u2014\u76ee\u524d\u8ba4\u8bc6\u548c\u5efa\u8bae(2010\u5e74\u4fee\u8ba2\u7248)[J]. \u4e2d\u534e\u5fc3\u5f8b\u5931\u5e38\u5b66\u6742\u5fd7,2010,14(4):245-259.<\/p>\n

[4] EPSTEIN AE, DIMARCO JP, ELLENBOGEN KA, et al. 2012 ACCF\/AHA\/HRS focused update incorporated into the ACCF\/AHA\/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society [J]. J Am Coll Cardiol, 2013, 61(3): e6-75.<\/p>\n

[5] KUSUMOTO FM, SCHOENFELD MH, BARRETT C, et al. 2018 ACC\/AHA\/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society [J]. Circulation, 2019, 140(8): e382-e482.<\/p>\n

[6] \u4e2d\u534e\u533b\u5b66\u4f1a\u5fc3\u7535\u751f\u7406\u548c\u8d77\u640f\u5206\u4f1a, \u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u5fc3\u5f8b\u5b66\u4e13\u4e1a\u59d4\u5458\u4f1a. \u5fc3\u52a8\u8fc7\u7f13\u548c\u4f20\u5bfc\u5f02\u5e38\u60a3\u8005\u7684\u8bc4\u4f30\u4e0e\u7ba1\u7406\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc62020 [J]. \u4e2d\u534e\u5fc3\u5f8b\u5931\u5e38\u5b66\u6742\u5fd7, 2021, 25(3): 185-211.<\/p>\n

[7] \u4e2d\u534e\u533b\u5b66\u4f1a\u5fc3\u7535\u751f\u7406\u548c\u8d77\u640f\u5206\u4f1a, \u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u5fc3\u5f8b\u5b66\u4e13\u4e1a\u59d4\u5458\u4f1a. \u666e\u901a\u5fc3\u810f\u8d77\u640f\u5668\u548c\u690d\u5165\u578b\u5fc3\u5f8b\u8f6c\u590d\u9664\u98a4\u5668\u624b\u672f\u64cd\u4f5c\u89c4\u8303\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6\uff082023\uff09 [J]. \u4e2d\u534e\u5fc3\u5f8b\u5931\u5e38\u5b66\u6742\u5fd7, 2023, 27(3): 188-224.<\/p>\n

[8]KRONBORG M B, FRAUSING M, MALCZYNSKI J, et al. Atrial pacing minimization in sinus node dysfunction and risk of incident atrial fibrillation: a randomized trial[J]. Eur Heart J, 2023,44(40):4246-4255.<\/p>\n

[9]REDDY Y, KOEPP K E, CARTER R, et al. Rate-adaptive atrial pacing for heart failure with preserved ejection fraction: the RAPID-HF randomized clinical trial[J]. JAMA, 2023,329(10):801-809.<\/p>\n

[10]INFELD M, WAHLBERG K, CICERO J, et al. Effect of personalized accelerated pacing on quality of life, physical activity, and atrial fibrillation in patients with preclinical and overt heart failure with preserved ejection fraction: the myPACE randomized clinical trial[J]. JAMA Cardiol, 2023,8(3):213-221.<\/p>\n

[11] MCINTYRE W F, BENZ A P, BECHER N, et al. Direct oral anticoagulants for stroke prevention in patients with device-detected atrial fibrillation: a study-level meta-analysis of the NOAH-AFNET 6 and ARTESiA Trials[J]. Circulation, 2023.<\/p>\n

[12] KIRCHHOF P, TOENNIS T, GOETTE A, et al. Anticoagulation with edoxaban in patients with atrial high-rate episodes[J]. N Engl J Med, 2023,389(13):1167-1179.<\/p>\n

[13] HEALEY J S, LOPES R D, GRANGER C B, et al. Apixaban for stroke prevention in subclinical atrial fibrillation[J]. N Engl J Med, 2024,390(2):107-117.<\/p>\n

[14] LATANICH C A, ANDERSON J A. Shockwave intravascular lithotripsy facilitated transvenous lead extraction[J]. JACC Clin Electrophysiol, 2023,9(8 Pt 2):1585-1592.<\/p>\n

[15] FERRO E G, KRAMER D B, LI S, et al. Incidence, treatment, and outcomes of symptomatic device lead-related venous obstruction[J]. J Am Coll Cardiol, 2023,81(24):2328-2340.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"

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