猫肥厚型心肌病并发严重肺高压的诊治  

Diagnosis and Treatment of Feline Hypertrophic Cardiomyopathy Complicated with Severe Pulmonary Hypertension

作　　者：陆梓杰 孙艳争[2] 张天广 迟万怡 LU Zijie;SUN Yanzheng;ZHANG Tianguang;CHI Wanyi(China Agricultural University Veterinary Teaching Hospital,Beijing 100193,China;College of Veterinary Medicine,China Agricultural University,Beijing 100193,China;RingPai Pet Hospital,Zhengzhou 450000,China;Beijing Agricultural Vocational and Technical College,Beijing 102442,China)

机构地区：[1]中国农业大学动物医院,北京海淀100193 [2]中国农业大学动物医学院,北京海淀100193 [3]河南瑞派喵宠物医院,河南郑州450000 [4]北京农业职业技术学院,北京房山102442

出　　处：《中国兽医杂志》2024年第2期141-144,共4页Chinese Journal of Veterinary Medicine

摘　　要：猫肺高压(PH)相对少见,发病隐蔽,诊断难度高,缺乏相关治疗经验。2019年5月,笔者接诊了1例因呼吸困难、腹围增大前来就诊的患猫,通过详细的病史调查和体格检查初步怀疑患猫存在左心和右心充血的问题。超声心动检查结果显示,患猫存在严重的左心室局灶性增厚,针对右心的进一步检查确认了严重PH。结合血压检查结果和患猫的整体发病特点,患猫最终确诊为肥厚型心肌病(HCM)并发严重PH,且已出现全心充血性心衰。笔者在治疗患猫心衰方案的基础上添加了枸橼酸西地那非。患猫自确诊并治疗后存活了8个月。笔者希望通过本文向广大兽医师阐述猫PH的诊断要点,尤其是超声心动检查时需要注意的影像学表现,同时分享枸橼酸西地那非治疗猫PH的一些经验。Feline pulmonary hypertension(PH)is relatively uncommon,with subtle symptoms,high diagnostic difficulty,and current lack of relevant treatment experience.In May 2019,the author received a cat for examination due to dyspnea and abdominal distension.Detailed medical history and physical examination led to a preliminary suspicion of left and right heart congestion.Echocardiography revealed severe focal thickening of the left ventricle,and further examination confirmed severe PH affecting the right heart.Combining blood pressure results with the cat's overall clinical features,a final diagnosis of hypertrophic cardiomyopathy(HCM)complicated with severe PH and congestive heart failure was made.The author added sildenafil to the cat's heart failure treatment plan.The cat survived for 8 months after diagnosis and treatment.This article aims to elucidate the diagnostic key points of feline PH,especially the imaging manifestations to be noted during echocardiography,and to share experiences with sildenafil in treating feline PH.

关 键 词：猫 肥厚型心肌病(HCM) 肺高压(PH) 枸橼酸西地那非 

分 类 号：S829.3[农业科学—畜牧学]