摘要
目的:总结60岁以上老年S状室间隔患者与老年非S状室间隔肥厚型梗阻性心肌病(HOCM)患者行心肌化学消融术(PTSMA)治疗的疗效及并发症发生情况。方法:对2009-07-2013-06实施PTSMA治疗的60岁以上老年S状室间隔患者与老年非S状室间隔HOCM患者的临床资料和化学消融结果进行比较。结果:共4例老年S状室间隔患者接受PTSMA治疗,术后比术前静息及期前收缩后左心室流出道压力阶差明显下降(11.5mmHg︰56.5mmHg,P=0.037;32.5mmHg︰121.5mmHg,P=0.037)。老年非S状室间隔HOCM患者共15例接受PTSMA治疗,术后比术前静息及期前收缩后左心室流出道压力阶差亦明显下降(11.0mmHg︰67.0mmHg,P=0.001;42.0mmHg︰123.0mmHg,P=0.000)。老年S状室间隔患者与老年非S状室间隔HOCM患者手术前后静息及期前收缩后左心室流出道压力阶差变化值无明显差异(△45.0 mmHg︰△50.0mmHg,P=0.874;△84.5mmHg︰△80.0mmHg,P=0.874)。两组总并发症发生率无明显差异(P=1.000)。所有患者出院后均随访1年,无新发死亡患者,无心力衰竭加重,无心肌梗死发生,无再次行PTSMA治疗患者。结论:老年S状室间隔患者可能同老年非S状室间隔HOCM患者一样,行PTSMA治疗均有明显疗效。
Objective：To retrospectively compare the effectiveness and complication of percutanous translumi- nal septal myocardial ablation（PTSMA） performed on hypertrophic obstructive cardiomyopathy （HOCM） patients with sigmoid or neutral septum. Method： We retrospectively analyzed the data from aged sigmoid septum patients and aged neutral septum patients with HOCM treated by PTSMA from July 2009 to Jun 2013, including clinical data, and the results and complications of PTSMA were assessed. Results：There were 4 aged sigmoid septum pa- tients received PTSMA in which left ventricular outflow tract pressure gradient （LVOTPG） at rest and post pre- mature beat dropped significantly after operation（ll. 5 mmHg vs 56.5 mmHg, P：0. 037-32.5 mmHg vs 121.5 mmHg, P=0. 037）. There were 15 aged neutral septum patients with HOCM received PTSMA in which left ven- tricular outflow tract pressure gradient （LVOTPG） at rest and post premature beat dropped significantly after op- eration（ll.0mmHgvs67.0mmHg, P=0.001;42.0mmHgvs123.0mmHg, P--0.000）. And the decline value at rest and post premature beat had no significant difference （Δ45.0 mmHg vs Δ50.0 mmHg, P：0. 874;Δ84. 5 vs Δ80.0 mmHg, P=0. 874）between two groups. During operation and post-operative in the hospital, the total complication rate had no significant difference（P： 1.00）between two groups. There were no death, no myocardial infarction, no heart failure and no 2nd PTSMA patients during the 1 year of follow-up. Conclusion： The PTSMA for aged sigmoid septum HOCM patients is as effective as for aged neutral septum patients with HOCM.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2015年第5期556-559,共4页
Journal of Clinical Cardiology
关键词
心肌病
肥厚性梗阻型
经皮室间隔心肌化学消融术
老年S状室间隔
hypertrophic obstructive cardiomyopathy
percutaneous transluminal septal myocardial ablation
the aged sigmoid septum
