肥厚型梗阻性心肌病化学消融治疗近期疗效观察  

Short-term Effect of Percutaneous Transluminal Septal Myocardium Ablation on Hypertrophic Obstructive Cardiomyopathy

作　　者：魏明[1] 方中[1] 孙一康[1] 潘家华[1] 郭涛[1] 喻卓[1] 

机构地区：[1]昆明医学院第一附属医院心内科,云南昆明650032

出　　处：《昆明医学院学报》2010年第5期109-111,117,共4页Journal of Kunming Medical College

摘　　要：目的评价经皮腔内冠状动脉室间隔化学消融术(PTSMA)治疗肥厚型梗阻性心肌病的近期疗效.方法 7例肥厚型梗阻性心肌病患者,平均(47.1±13.4)岁,均采用95%无水酒精行PTSMA,计算术前及术后经导管测定的左心室流出道压力阶差(LVOTPG),术后所有患者均定期复查超声心动图,随访观察3个月.结果术前静息状态的LVOTPG为(92.7±24.3)mmHg,术后为(30.5±25.7)mmHg;消融前、后LVOTPG差异有统计学意义(P<0.01).术前超声心动图示左室流出道(LVOT)为(7.8±1.3)mm,室间隔(IVS)为(21.6±3.0)mm,术后3个月复查超声心动图示LVOT为(10.6±1.5)mm,IVS为(17.2±2.6)mm;与术前比较差异均有统计学意义(P<0.05).7例患者术后3个月随访均存活,无晕厥及心绞痛复发,心功能改善.结论 PTSMA能明显降低LVOTPG,改善临床症状,提高心功能,对治疗肥厚型梗阻性心肌病近期疗效确切.Objective To evaluate the short-term effect of percutaneous transluminal septal myocardial ablation（PTSMA） on hypertrophic obstructive cardiomyopathy（HOCM） .Methods The average age of 7 patients with hypertrophic obstructive cardiomyopathy was（47.1±13.4） years old.Transcatheter was injected with 95% alcohol by the way of PTSMA.Left ventricular outflow tract pressure gradient were calculated through transcatheter measurement before ablation and immediately after ablation. UCG were recorded and the complications were observed during and 3 months after ablation.Results LVOTPG was（92.7 ±24.3） mmHg and（30.5±25.7） mmHg before and after ablation respectively.There was significantly different before and after the ablation（P 0.01） .Preoperative echocardiogram showed left ventricular outflow tract（LVOT） was（7.8 ± 1.3） mm and interventricular septum（IVS） was（21.6 ± 3.0） mm;after 3 months follow-echocardiography showed LVOT was（10.6 ± 1.5） mm,IVS was（17.2 ± 2.6） mm.There were significant differences before and after the ablation（P0.05） .All patients after 3 months follow-up were alive and their cardiac function was improving,with no recurrence of syncope and angina pectoris.ConclusionPTSMA can significantly reduce the LVOTPG,improve the clinical symptoms,and improve cardiac function.The short-term effect of PTSMA on hypertrophic obstructive cardiomyopathy is obviously good.

关 键 词：经皮室间隔心肌化学消融术 肥厚型梗阻性心肌病 近期疗效 

分 类 号：R542.2[医药卫生—心血管疾病]