基于指南欧美运动员肥厚型心肌病的诊疗策略及启示  

Diagnostic and Therapeutic Strategies for Hypertrophic Cardiomyopathy in European and America Athletes Based on Guidelines and Their Implications

作　　者：陈浩 杨玲[1] CHEN Hao;YANG Ling(School of Physical Education,Shaoguan University,Shaoguan Guangdong,512005,China)

机构地区：[1]韶关学院体育学院,广东韶关512005

出　　处：《四川体育科学》2025年第2期41-49,共9页Sichuan Sports Science

基　　金：广东省哲学社会科学规划2024年度学科共建项目(GD24XTY12);2023年度国家体育总局科技创新项目(23KJCX023)。

摘　　要：肥厚型心肌病(HCM)是欧美运动员导致心脏骤停(SCA)/心源性猝死(SCD)主要病因类型。该研究运用文献资料法、逻辑推理法等方法,论证和探析欧美心脏病协会(AHA/ACC、EAPC、ESC)关于运动员HCM的赛前评估、康复治疗和参赛资格等内容。研究认为,尽管AHA和ESC围绕心电图(ECG)检查是否纳入常规筛查持有相对立态度,但是ECG作为常规诊断工具其诊断效果优于仅凭病史和体征应用,而且为终极筛查选择适宜诊断工具提供疾病迹象信息。另外,建立运动员以疾病症状风险分层的“量化指标”不仅可以辨别心脏重塑(EICR)与病理特征,而且能够为康复治疗和重返赛场(RTP)提供参考依据。基于此,从主体、基础、对象和内容等4个层面制定与完善中国运动员HCM的诊疗指南,对于构建预防心肌疾病与竞技训练的理论体系具有重要意义。Hypertrophic cardiomyopathy(HCM)is the leading cause of sudden cardiac arrest(SCA)/sudden cardiac death(SCD)in European and America athletes.By using the methods of literature review and logical reasoning,this study demonstrated and analyzed the contents of AHA/ACC,EAPC,ESC on the pre-competition evaluation,rehabilitation treatment and eligibility of athletes with HCM.The study concluded that although AHA and ESC have opposing views about whether or not to include routine screening with ECG,However ECG as a routine diagnostic tool has better diagnostic results than using tests based solely on history and physical examination,and provides disease clues for the appropriate diagnostic tool for the final screening.In addition,the establishment of'Quantitative Index"for risk stratification of athletes by disease symptoms can not only Exercise-Induced Cardiac Remodeling(EICR)from pathological features,but also provide reference for rehabilitation therapy and Return to play(RTP).Based on this,from the subject,the foundation,the object,the content and and so on four levels to formulate and consummates the Chinese athlete HCM diagnosis and treatment guide,therefore,it is of great significance for the construction of a theoretical system for the prevention of myocardial diseases and competitive training.

关 键 词：运动员 肥厚型心肌病 诊疗指南 心脏重塑 重返赛场 

分 类 号：G804.5[文化科学—运动人体科学]