肥厚型梗阻性心肌病经皮室间隔化学消蚀术的疗效观察

Results after percutaneous transluminal septal myocardial ablation of hypertrophic obstructive cardiomyopathy

目的:评价经皮经腔室间隔心肌化学消蚀术(PTSMA)治疗肥厚型梗阻性心肌病(HOCM)的近期疗效。方法:对象为2002年4月-2003年12月行PTSMA的HOCM 32例。消融前,术中,术后1月和6月时分别测量室间隔(IVS)厚度,左室流出道压力阶差(LVOTG)等指标。结果:超声检测:平均静息LVOTG术前为85.7±35.4 mmHg,术后即刻,术后1月和6月分别为37.5±16.2 mmHg、26.8±17.4 mmHg、18.7±12.6 mmHg,差异非常显著(P<0.001);IVS术前平均厚度为28.8±7.1 mmHg,术后1、6月时分别为20.2±7.3 mmHg,13.5±6.5 mmHg (P<0.01)。结论:PTSMA能显著持续降低LVOTG,近期疗效显著、可靠。

Objective; To evaluate the early results after percutaneous transluminal septal myocardial ablation (PTSMA) of hypertrophic obstructive cardiomyopathy (HOCM). Methods:From Apr 2002 to Dec 2003 the 32 HOCM patients were performed PTSMA. Before and after the septal branches of coronary artery were occluded by 95% alcohol , the changes of left ventricular outflow-tract gradient (LVOTG) and ECG were measured. The interventricular septal hypertrophy (IVS) and LVOTG were measured by echocardiography (echo) before and just after PTSMA and 1 month, 6 months after PTSMA. Results: Echo showed that LVOTG at rest were 85.7±35. 4 mmHg, and those of just after PTSMA, 1 month and 6 months after PTSMA were 37. 5±16. 2 mmHg,26. 8±17. 4 mmHg, 18. 7±12. 6 mmHg (P<0. 001). IVS reduced from 28. 8±7. 1 mm before PTSMA to 20. 2±7. 3 mm and 13. 5±6. 5 mm 1 month and 6 months after PTSMA (P<0. 01). Conclusion: PTSMA reduce LVOTG significantly and has a good and significant recent result in the treatment of HOCM.