摘要
目的综合评价国内外近十年来经皮间隔心肌消融术(PTSMA)与室间隔心肌切除术(VSM)治疗肥厚型梗阻性心肌病(HOCM)的疗效。方法通过文献检索获得有关PTSMA与VSM治疗HOCM的研究文献,分析比较两种方法对HOCM患者左心室流出道压差(LVOTPG)、室间隔厚度(IVS)、心功能分级(NYHA分级)及治疗后不良反应的指标有无差异。结果有7篇文献进入Meta分析,共获得病例362例,其中PTSMA组199例,VSM组163例。Meta分析结果显示,两组患者LVOTPG、IVS、NYHA分级变化及不良反应基本相同,但VSM组结果更接近正常。敏感性分析显示两组在LVOTPG、IVS及NYHA分级水平的差异结果可靠。结论 PTSMA治疗HOCM的疗效略低于VSM,但仍为非创性治疗HOCM的有效方法。
Objective To synthetically evaluate the efficacy ofpercutaaeous transluminal septal myocardial ablation （PTSMA） and ventricular septal myectomy （VSM） in hypertrophic obstructive cardiomyopathy （HOCM） at domestically and overseas over the past decades. Methods Through literature searching, the literatures about treat- ment of PTSMA and VSM in HOCM were obtained. Meta analysis was used to compare the differences of left ventric- ular outflow tract pressure gradient （LVOTPG）, intervenlxicular septal thickness （IVS）, NYHA class and postoperative adverse reactions through quantitative analysis before and after treatment in two groups. Results There were 7 litera- tures into the recta-analysis, involving a total of 362 patients, including 199 cases in PTSMA group and 163 cases in VSM group. Meta-analysis showed no significant differences in changes of LVOTPG, IVS, NYHA class and postoper- ative adverse reactions before and after treatment in two groups, but the results in VSM group was closer to normal. The sensitivity analysis showed that the differences of changes of LVOTPG, IVS, NYHA class and postoperative ad- verse reactions in two groups were reliable. Conclusion Though the efficacy of PTSMA is temporarily slightly low- er than that of VSM in HOCM, it is still an effective method of non-invasive treatment.
出处
《海南医学》
CAS
2013年第10期1541-1544,共4页
Hainan Medical Journal
基金
国家自然科学基金(编号:81170085)
关键词
经皮室间隔消融术
室间隔心肌切除术
肥厚型梗阻性心肌病
META分析
Percutaneous transluminal septal myocardial ablation
Ventricular septal myectomy
Hypertro-phic obstructive cardiomyopathy
Meta analysis
