心脏去交感神经术在恶性室性心律失常中的应用  

Cardiac sympathetic denervation for maglignant ventricular arrhytmias

作　　者：郑黎晖[1] 高路[2] 姚焰[1] ZHENG Li-hui;GAO Lu;YAO Yan(Arrhythmia Center,Chinese Academy of Medical Sciences and Peking Union Medical College,National Center for Cardiovascular Diseases,Furwai Hospital,Bejing 100037,China;Department of Cardiology,Bejing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045.China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心律失常中心,北京市100037 [2]首都医科大学附属北京儿童医院心内科,北京市100037

出　　处：《中国心血管病研究》2020年第8期683-688,共6页Chinese Journal of Cardiovascular Research

基　　金：中央级公益性科研院所基本科研业务费(2019XK320062);国家重点研发计划(2017YFC1307800);首都临床诊疗技术研究及示范应用项目(Z191100006619019)。

摘　　要：恶性室性心律失常包括器质性和遗传性两大类,可导致猝死严重危害人类健康.这些心律失常发生多与心脏交感神经激活有关.心脏交感神经切除术(CSD)通过切除下半部分星状神经节和前四对胸交感神经节可降低心脏交感神经活性,是恶性室性心律失常有效、安全的治疗手段.对于长QT综合征和儿茶酚胺敏感性多形性室性心动过速(CPVT),单纯左侧CSD可能就已足够;对于器质性心脏病合并室性心律失常,双侧CSD可能具有更好疗效.Malignant ventricular arrhythmias(VAs)are composed of structural and inherited ventricular arrhythmias,which are a major cause of sudden cardiac death.It has been long recognized that the sympathetic activation plays a key role in the initiation and perpetuation of these malignant VAs.Cardiac sympathetic denervation(CSD)is a surgical procedure that removes the lower third to half of the sellate ganglia and T2-T4 thoracic ganglia.Some evidence supports that CSD may be more efctive at preventing recurrent VAs.It seems that for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia(CPVT)left CSD alone is enough,however,for VAs with structural heart disease,bilateral CSD may be requisite.

关 键 词：室性心律失常 器质性心脏病 遗传性室性心律失常 心交感神经切除术 

分 类 号：R541.7[医药卫生—心血管疾病]