肥厚型梗阻性心肌病室间隔心肌消融术的国专家共识中华医学会心血管病学分会中华心血管病杂志编辑委员会室间隔心肌消融术治疗专题组肥厚型梗阻性心肌病(hypertrophicobstructivecardiomyopathy，HOCM)是肥厚型心肌病的一种，因肥厚室间隔造成心室梗阻而得名。目前尚无理想的治疗措施，药物治疗为首选。但部分HOCM患者药物治疗效果不佳或不能耐受，这部分患者需要借助非药物治疗方法。非药物治疗方法包括手术和介入治疗，经皮穿刺腔内间隔心肌消融术（percutaneoustransluminalseptalmyocardialablation,PTSMA）是一种介入治疗手段，其原理是通过导管注入无水酒精，闭塞冠状动脉的间隔支，使其支配的肥厚室间隔心肌缺血、坏死、变薄、收缩力下降，使心室流出道梗阻消失或减轻，从而改善HOCM患者的临床症状[1]。10.3760/cma.j.issn.0253-3758.2011.10.004万方数据其压差万方数据心包填塞万方数据静息万方数据@@[1]KimmelstielC,KrishnamurthyB，WeintraubA，等.酒精室间隔消融术与肥厚型心肌病.中华心血管病杂志，2009，37:1074-1077.@@[2]WallerBF,MaronBJ,EpsteinSE,etal.Transmuralmyocardialinfarctioninhypertrophiccardiomyopathy:acauseofconversionfromleftventricularasymmetrytosymmetryandfromnormal-sizedtodilatedleftventricularcavity.Chest,1981,79:461-465.@@[3]SigwartU,GribicM,PayorM,etal.Wallmotionduringballoonocclusion.//SigwartU,HeintzenPH.Ventricularwallmotion.Stuttgart:GeorgThieme,1983:206-210.@@[4]GietzenF,LeunerC,GerenkampT,etal.Reliefofobstructioninhypertrophiccardiomyopathybytransientocclusionofthefirstseptalbranchoftheleftcoronaryartery.EurHeartJ,1994,15(Suppl):125-130.@@[5]SigwartU.Non-surgicalmyocardialreductionforhypertropicobstructivecardiomyopathy.Lancet,1995,346:211-214.@@[6]赵林阳，王大伟，杨平，等.经导管化学消蚀心肌治疗肥厚性梗阻型心肌病（附一例报告）.中华心血管病杂志，1998，26:70-71.@@[7]中华心血管病杂志编委会经皮经腔间隔心肌消融术治疗专题组.经皮经腔间隔心肌消融术治疗的参考意见.中华心血管病杂志，2001，29:434-435.@@[8]SeggewissH,FaberL,GleichmannU.Percutaneoustransluminalseptalablationinhypertropicobstructivecardiomyopathy.ThoracCardiovascSurg,1999,47:94-100.@@[9]AlamM,DokainishH,LakkisN.Alcoholseptalablationforhypertrophicobstructivecardiomyopathy:asystematicreviewofpublishedstudies.JIntervCardio1,2006,19:319-327.@@[10]MaronBJ,McKennaWJ,DanielsonGK,etal.AmericanCollegeofCardiology/EuropeanSocietyofCardiologyclinicalexpertconsensusdocumentonhypertrophiccardiomyopathy.AReportoftheAmericanCollegeofCardiologyFoundationTaskForceonClinicalExpertConsensusDocumentsandtheEuropeanSocietyofCardiologyCommitteeforPracticeGuidelines.JAmCollCardiol,2003,42:1687-1713.@@[11]SeggewissH,RigopoulosA,WelgeD,etal.Long-termfollow-upafterpercutaneousseptalablationinhypertrophicobstructivecardiomyopathy.ClinResCardio1,2007,96:851-855.@@[12]AlamM,DokainishH,LakkisNM.Hypertrophicobstructivecardiomyopathy-alcoholseptalablationvs.myectomy:ametaanalysis.EurHeartJ,2009,30:1080-1087.@@[13]AgarwalS,TuzcuEM,DesaiMY,etal.Updatedmeta-analysisofseptalalcoholablationversusmyectomyforhypertrophiccardiomyopathy.JAmCollCardiol,2010,55:823-834.@@[14]LyneJC,KilpatrickT,DuncanA,etal.Long-termfollow-upofthefirstpatientstoundergotranscatheteralcoholseptalablation.Cardiology,2010,116:168-173.@@[15]LeonardiRA,KransdorfEP,SimelDL,etal.Meta-analysesofseptalreductiontherapiesforobstructivehypertrophiccardiomyopathy:comparativeratesofoverallmortalityandsuddencardiacdeathaftertreatment.CircCardiovascInterv,2010,3:97-104.@@[16]辽宁省化学消融术协作组.经皮经冠状动脉室间隔化学消融万方数据术...
