肺动脉环缩术治疗儿童扩张型心肌病研究进展  

Advances in the treatment of pulmonary artery banding in children with dilated cardiomyopathy

作　　者：李伟 黄萍 汪周平 张丽 Li Wei;Huang Ping;Wang Zhouping;Zhang Li(Department of cardiology,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心心脏内科,广州510120

出　　处：《中华胸心血管外科杂志》2024年第4期248-250,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：广州市科技局市校联合资助基金项目(2024A03J0951,202201020606)。

摘　　要：扩张型心肌病(dilated cardiomyopathy,DCM)是儿童一种少见但严重的心肌病,是儿童心源性猝死主要原因之一。DCM主要是由于心肌病变导致心室扩大、收缩功能障碍,甚至心力衰竭,其临床表现为心律失常、猝死以及心力衰竭等。目前治疗措施包括去除病因、控制心衰及心律失常、预防猝死和栓塞,临床上以药物治疗为主。给予最佳药物治疗DCM,仍出现进行性顽固性心力衰竭,外科手术治疗可改善远期生存率,外科手术治疗主要包括心脏再同步治疗、左心室辅助装置、心脏移植等。2007年Schranz首先报道肺动脉环缩术(pulmonary artery banding,PAB)治疗终末期DCM取得良好效果。目前国外有多项的临床研究证实PAB能明显改善儿童终末期DCM的心功能,国内尚未见相关文献报道。本文就DCM的治疗现状;PAB治疗扩张型心肌病的机制及优、缺点;PAB治疗扩张型心肌病的效果;PAB应用前景及未来相关研究方向四项内容作一综述。Dilated cardiomyopathy(DCM)is a rare and serious cardiomyopathy in children.DCM is mainly a disease caused by ventricular enlargement or systolic dysfunction,resulting in heart failure,and its clinical manifestations are arrhythmia,sudden death and heart failure.At present,the treatment measures include removal of the cause,control of heart failure and arrhythmia,prevention of sudden death and embolism,clinical symptomatic treatment with drugs,and surgical treatment including cardiac resynchronization therapy,left ventricular assist device,heart transplantation,etc.Pulmonary artery banding used to treat end-stage DCM was the first reported by Germany scholars in 2007,and good results have been obtained.Some clinical studies abroad have confirmed that PAB can significantly improve cardiac function in children with end-stage DCM,but there is no relevant literature report in China nowadays.Therefore,it is necessary to keep abreast of the progress of PAB in DCM treatment.This article reviews the current status and prognosis of PAB treatment in children with DCM,in order to provide reference for DCM treatment and further research.Therefore,this article reviews the progress of PAB in the treatment of DCM in children:(1)the current status of DCM;(2)the mechanism,advantages and disadvantages of PAB in the treatment of dilated cardiomyopathy;(3)effect of PAB in the treatment of dilated cardiomyopathy;(4)the prospect of PAB and related research in the future.

关 键 词：顽固性心力衰竭 外科手术治疗 收缩功能障碍 心脏再同步治疗 扩张型心肌病 心源性猝死 心脏移植 心肌病变 

分 类 号：R726.5[医药卫生—儿科]