目的 探讨儿童永久起搏器植入术围手术期心肌损伤及心功能改变。方法 回顾分析2018 年11 月至2019年10 月收治的因各类心动过缓行永久起搏器植入术患儿的临床资料，比较起搏器植入术前、术后1 天、术后1 周患儿血肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）、N末端B型利钠肽原（NT-proBNP），以及术前与术后1 周经胸超声心动图检查的左心室舒张末期内径（LVEDD）Z值和左心室射血分数（LVEF）。结果 入选21 例患儿，男8 例、女13 例，年龄8.0岁（4.0~11.0岁），体质量26.1kg（15.3~45.8kg）。植入双腔起搏器15 例，植入单腔起搏器6 例。21 例患儿在心脏起搏器植入术前、术后1 天和术后1 周cTnI 和CK-MB水平的差异有统计学意义（P< 0 . 001）。cTnI 和CK-MB在术后1 天最高，分别高于术前和术后1周，差异有统计学意义（P<0.05）。21例患儿心脏起搏器植入术后1周的LVDD-Z值和LVEF值均低于术前，差异有统计学意义（P< 0 . 05）。结论 心动过缓患儿植入永久起搏器后可出现短暂、轻度、可逆的心肌损伤，但对心功能有保护作用。

Objective To investigate perioperative myocardial injury and cardiac function changes in children undergoing permanent pacemaker implantation. Methods The clinical data of children who underwent permanent pacemaker implantation for various types of bradycardia from November 2018 to October 2019 were reviewed. The blood troponin I (cTnI), creatine kinase (CK)-MB isoenzyme, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) of the children were compared before the pacemaker implantation operation, 1 day after and 1 week after the operation. The left ventricular end diastolic diameter (LVEDD) Z value and left ventricular ejection fraction (LVEF) by transthoracic echocardiography before and 1 week after the operation were compared. Results Twenty-one children ( 8 boys and 13 girls) were included, with an age of 8 . 0 ( 4 . 0 - 11 . 0 ) years and a weight of 26 . 1 ( 15 . 3 - 45 . 8 ) kg. Dual-chamber pacemakers were implanted in 15 cases and single-chamber pacing in 6 cases. There were statistically significant differences in the levels of cTnI and CK-MB in 21 children before, 1 day after and 1 week after pacemaker implantation (P<0 . 001). The levels of cTnI and CK-MB were the highest one day after operation, which were higher than those before and one week after operation, respectively, with statistical significance (P<0 . 05 ). The LVDD-Z and LVEF values of 21 children one week after pacemaker implantation were lower than those before implantation, and the difference was statistically significant (P<0.05 ). Conclusions Children with bradycardia may experience shortterm, mild and reversible myocardial damage after implantation of a permanent pacemaker, but it has a protective effect on heart function.