超声心动图评价肥厚型梗阻性心肌病患者经皮室间隔心肌消融术后疗效  

Assessment of effect in patients with hypertrophic obstructive cardiomyopathy after percutaneous transluminalseptal myocardial ablation using echocardiography

作　　者：张丽娟[1] 熊峰[1] 王淑珍[1] 张梅[1] 冯坤[1] 刘春霞[1] 唐炯[1] 

机构地区：[1]成都市第三人民医院心内科,四川成都610031

出　　处：《西部医学》2015年第3期377-379,共3页Medical Journal of West China

基　　金：四川省卫生厅科研课题(120538)

摘　　要：目的应用超声心动图评价肥厚型梗阻性心肌病(HOCM)患者经皮室间隔心肌消融术(PTSMA)后疗效。方法收集23例行PTSMA治疗的HOCM患者,于PTSMA术前3天、术后3个月及术后1年接受超声心动图检查。获取左心室舒张末期前后径、室间隔舒张末期厚度、左室后壁舒张末期厚度、左心室射血分数、左心室流出道压力阶差等参数,对二尖瓣前叶收缩期前向运动评分。比较PTSMA术前3天、术后3个月及术后1年上述参数之间的差异。结果与术前相比,HOCM患者PTSMA术后3个月及术后1年IVSd、LVEF、LVOTG减小,差异均有统计学意义(均P<0.05);术后1年LVDd增大,差异有统计学意义(P<0.05);而LVPWd手术前后差异无统计学意义(P>0.05);二尖瓣SAM评分差异均有统计学意义(P<0.05)。结论 PTSMA能显著改善HOCM患者左室流出道梗阻及心功能。超声心动图定量评价HOCM患者PTSMA术后疗效,可为临床提供更为精确的信息。Objective To assess the effect in patients with hypertrophic obstructive cardiomyopathy（HOCM）after percutaneous transluminalseptal myocardial ablation（PTSMA）using echocardiography.Methods 23 patients with HOCM after PTSMA were enrolled into this study.All patients received echocardiography examinationa at 3 days before and 3 months and 1 year after PTSMA.The anatomical and mechanical parameters were derived using echocardiography,including left ventricle end-diastolic diameter（LVDd）,interventricular septum end-diastolic thickness（IVSd）,left ventricular posterior wall end-diastolic thickness（LVPWd）,left ventricular ejection fraction（LVEF）,left ventricular outflow-trace gradient（LVOTG）,score of systolic anterior motion.The parameters of the HOCM patients were compared at 3 days before and 3 months and 1 year after PTSMA.Results Compared with HOCM patients before PTSMA,IVSd,LVEF and LVOTG in patients 3 months and 1year after PTSMA significantly decreased（P〈0.05）.LVDd in patients 3months and 1 year after PTSMA significantly increased（P〈0.05）.There was significant difference in score of systolic anterior motion（P〈0.05）.Conclusion The left ventricular outflow tract obstruction and cardiac function in patients with HOCM after PTSMA are significantly improved.Quantitative assessment of effect in patients with HOCM after PTSMA using echocardiography provides precise information to clinic.

关 键 词：超声心动描记术 肥厚型梗阻性心肌病 经皮室间隔心肌消融术 左心室流出道压力阶差 

分 类 号：R542.21[医药卫生—心血管疾病]