摘要目的：研究符合植入型心律转复除颤器( ICD)适应证的患者中,植入ICD或心脏再同步治疗除颤器( CRT-D)患者与未植入ICD患者相比的远期预后和转归的差异。方法选取复旦大学附属中山医院心内科2007年6月至2008年6月住院的ICD适应证患者基本资料及相关病史,记录入院期间检查结果及治疗情况。出院5年后电话随访患者生存情况。结果入选152例ICD适应证患者中,植入ICD/CRT-D患者26例,其中一级预防患者11例,明显少于二级预防患者15例(9．3%对44．1%,P<0．001)。随访5年,失访23例,死亡33例,其中一级预防患者24例,二级预防患者9例。ICD/CRT-D植入组总死亡率显著低于未植入ICD/CRT-D组(7．7%对30．1% P=0．016)。5年生存时间与植入ICD/CRT-D无显著关联,(P=0．09)。多元回归分析显示,左心室射血分数(LVEF)和植入ICD/CRT-D与5年生存率显著相关(前者P=0．01,后者P=0．015)。结论植入ICD/CRT-D能提高ICD适应证患者的远期生存率。 LVEF仍是提示预后的敏感指标。

abstractsObjective To compare the outcome of 5-year survival in implantable cardioverter defibril-lator(ICD)indication patients with or without ICD/cardiac resynchronization therapy-defibrillator(CRT-D)im-plantation. Method Patients with ICD indication were consecutively recruited. The basic information,examina-tion results and treatment state were recorded. We got the information of vicious incidents or death of the pa-tients mainly by telephone. Results One hundred fifhy-two patients were enrolled for the study. Twenty six pa-tients were undergoing implantation, including 11 for primary and 15 for secondary prevention ( 9. 3% vs. 44. 1% P<0. 001). Twenty three patients missed and 33 patients died during 5-year follow-up. All-cause mor-tality in patients with ICD implantation was significant lower than that in patients without ICD implantation (7. 7% vs. 30. 1% P=0. 016). While the survival curve did not show statistical difference(P=0. 09). Logis-tic regression shown that left ventricular ejection fraction( LVEF) and ICD/CRT-D implantation both had a posi-tive correlation with survival rate(P=0. 01 and P=0. 015). Conclusion ICD/CRT-D can improve the long-term survival rate in patients with ICD indication. LVEF is a sensitive predictor for 5-year survival rate.