摘要
目的比较Liwen术治疗不同年龄肥厚型梗阻性心肌病(OHCM)患者的有效性及安全性,以明确其对高龄患者是否安全有效。方法本研究采用回顾性队列分析,纳入2019年12月至2024年4月在武汉亚洲心脏病医院接受Liwen术的108例OHCM患者,按年龄分为年龄<70岁组(n=88)和年龄≥70岁组(n=20)。采用倾向性评分匹配(PSM)方法控制基线混杂因素,评估两组患者的近期疗效与围术期安全性。结果Liwen术在不同年龄组中均表现出显著有效性,术后两组患者静息左心室流出道压差(LVOTG)均显著降低(年龄<70岁组:78.50 mmHg下降至12.00 mmHg,年龄≥70岁组:82.00 mmHg下降至25.00 mmHg,P<0.05)。室间隔厚度(IVST)也明显减小[年龄<70岁组:(2.30±0.48)cm减少至(1.71±0.26)cm,P<0.001;年龄≥70岁组:(2.30±0.48)cm减少至(1.72±0.44)cm,P<0.001]。两组患者的疗效相似,术前年龄≥70岁组静息LVOTG与IVST较年龄<70岁组比较差异无统计学意义[82.00(75.00,100.00)mmHg比78.50(64.50,116.00)mmHg,(2.30±0.48)cm比(2.30±0.48)cm,P>0.05]。年龄≥70岁组术后静息LVOTG和IVST与年龄<70岁组比较差异均无显著统计学差异[25.00(12.00,49.50)mmHg比12.00(8.00,37.75)mmHg,(1.72±0.44)cm比(1.71±0.26)cm,P>0.05]。两组ICU住院时间及并发症发生率无显著差异,提示Liwen术在不同年龄组中均具备良好安全性。结论Liwen术可显著改善OHCM患者左心室流出道梗阻(LVOT)及减少IVST,且在不同年龄的患者中均表现出可靠的安全性。
Objective To compare the efficacy and safety of the Liwen procedure in treating obstructive hypertrophic cardiomyopathy(OHCM)across different age groups,with a specific focus on its safety and effectiveness in elderly patients.Methods This study employed a retrospective cohort analysis involving 108 patients with OHCM who underwent Liwen surgery at Wuhan Asia Heart Hospital from December 2019 to April 2024.Patients were stratified into two groups:those age<70 years(n=88)and those age≥70 years(n=20).Propensity score matching(PSM)was used to control for baseline confounding factors.Short-term efficacy and perioperative safety were compared between the two groups.Results Within-group comparisons demonstrated that the Liwen procedure was significantly effective in both age groups.The resting left ventricular outflow tract gradient(LVOTG)decreased significantly after the procedure(age<70 group:from 78.50 mmHg to 12.00 mmHg;age≥70 group:from 82.00 mmHg to 25.00 mmHg;P<0.05).Interventricular septal thickness(IVST)also decreased significantly[age<70 group:from(2.30±0.48)cm to(1.71±0.26)cm,P<0.001;age≥70 group:from(2.30±0.48)cm to(1.72±0.44)cm,P<0.001].Between-group comparisons after PSM indicated no significant differences in preoperative resting LVOTG or IVST 82.00[(75.00,100.00)mmHg vs.78.50(64.50,116.00)mmHg,(2.30±0.48)cm vs.(2.30±0.48)cm,P>0.05].Postoperative resting LVOTG and IVST were also comparable between the two groups[25.00(12.00,49.50)mmHg vs.12.00(8.00,37.75)mmHg,IVST:(1.72±0.44)cm vs.(1.71±0.26)cm,P>0.05].There were no significant differences in ICU length of stay or complication rates,indicating favorable safety profiles across age groups.Conclusion The Liwen procedure significantly improves left ventricular outflow tract obstruction and reduces IVST in OHCM patients,Moreover,it demonstrates reliable safety in patients across different age groups.
作者
胡忠辉
肖红艳
陶凉
HU Zhong-hui;XIAO Hong-yan;TAO Liang(Department of Cardiac Surgery,Wuhan Asian Heart Hospital,School of Madicine,Wuhan University of Science and Technology,Wuhan 430022,China;Department of Cardiac Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430074,China)
出处
《中国心血管病研究》
2026年第1期42-47,共6页
Chinese Journal of Cardiovascular Research
