糜 腿� 赅痄桀腩汨� 翌祚觐泐 磬篦眍泐 鲥眚疣 盐 欣掏, 谚� 锰�. 悟溴脲龛� 桫屐梓羼觐� 犷脲珥� 皴痄鲟 � 囹屦铖觌屦铉�, 赅翦漯� 羿牦朦蝈蝰觐� 蝈疣镨� � 牦瘃铎 觌桧梓羼觐� 羿痨嚓铍钽梃

蒡� 疣犷蜞 铒筢腓觐忄磬 � 襻铕龛赍 耱囹彘 镱 爨蝈痂嚯囔 体驿箜囵钿眍� 66-� 磬篦眍� 耱箐屙麇耜铋 觐眙屦屙鲨� 桁. �.�. 翔痤泐忄 (�.翌祚�, 2007 泐�) 镱� 疱溧牿桢� 镳铘. 皖忤鲫钽� �.�. � �.�.�. 毋铕钿钼铋 �.�.

殃圜囹� 襻铕龛� 鲥腓觐� (纛痨囹 .PDF, 1,5 灬)

� 犷朦睇� 汨镥痱痤翳麇耜铋 赅痄桀扈铒囹桢� (檬滔) � 囗汨钽疣翳麇耜� 礤 桤戾礤眄� 觐痤磬痦� 囵蝈痂�扈 漕赅玎眍 疣玮栩桢 桫屐梃 扈铌囵溧 [1]. 相蝾腩汨� 爨臌� 桧蝠囔箴嚯 囵蝈痂�, 恹疣驽眄 沭噤桢眚 钺耱痼牿梃 戾驿� 脲恹� 驽塍漕麝铎 (似) � 囝痱铋 �怆��� 忸珈铈睇扈 镳梓桧囔� 疣玮栩�� 桫屐梃 扈铌囵溧 � 铋 赅蝈泐痂� 镟鲨屙蝾�. 茵囗耱铕嚓嚯�� 铌囵滂钽疣翳� � 桉镱朦珙忄龛屐 怛铕铋 蜿囗邂铋 汔痨铐桕� 镱玮铍�弪 忤珞嚯桤桊钼囹� 觐痤磬痦 囵蝈痂� [2]. � 磬耱��� 怵屐� 耦耱��龛� 觐痤磬痦钽� 牮钼铗铌� � 镟鲨屙蝾� 檬滔 铖蜞弪�� 爨腩桤篦屙睇�.

皱朦� 溧眄钽� 耦钺龛� �忤腩顸 镳钹磬腓玷痤忄螯 耜铕铖螯 觐痤磬痦钽� 镱蝾� � 镳铌耔爨朦眍� � 滂耱嚯铎 皴沆屙蜞� 镥疱漤彘 龛聃钿�� 囵蝈痂� (贤�) � � 钽栳帼� 囵蝈痂� (卫) 戾蝾漕� 蝠囗耱铕嚓嚯铋 铌囵滂钽疣翳彘 � 犷朦睇� 檬滔.

理嚯桤 铌囵滂钽疣祆 � 耧尻蝠钼 耜铕铖蝈� 觐痤磬痦 镱蝾觐� 恹镱腠屙 � 20 犷朦睇� 檬滔 (13 祗骥桧, 7 驽睐桧) � 忸琊囫蝈 铗 17 漕 46 脲� � 囫桁戾蝠梓羼觐� 纛痨铋 汨镥痱痤翳� 似. 锑犟桁嚯 沭噤桢眚 钺耱痼牿梃 � 恹躅漤铎 蝠嚓蝈 似 犷脲� 30 祆 痱.耱. � 镱觐� 疱汨耱痂痤忄腭� � 14 镟鲨屙蝾�. 灭箫矬 耩噔礤龛� 耦耱噔桦� 15 镳嚓蜩麇耜� 玟铕钼 漕狃钼铍邂. 项 忸琊囫蝮, 镱腩忸祗 耦铗眍龛�, 鬣耱铗� 皴痄鬻睇� 耦牮帙屙栝 (籽�) � 箴钼睨 囵蝈痂嚯钽� 溧怆屙�� (滥) 镟鲨屙螓 檬滔 耱囹桉蜩麇耜� 珥圜桁� 礤 疣珉梓嚯桉� 铗 镳嚓蜩麇耜� 玟铕钼 漕狃钼铍邂. 署栩屦��扈 怅膻麇龛� 镟鲨屙蝾� � 沭箫矬 犷朦睇� 檬滔 耠箧桦�: 蝾膣桧� 戾骀咫箐铟觐忸� 镥疱泐痤潢� (唐�) 15 祆 � 犷脲�, 铗眍龛� 蝾膣桧 唐� � 玎漤彘 耱屙觇 似 (茄似)>1,3, 眍痨嚯 珥圜屙�� 滥 � 铗耋蝰蜮桢 镳梓桧, 恹琨忄桴 疣玮栩桢 汨镥痱痤翳� 似. 绣汨耱疣鲨� 耧尻蝠钼 镱蝾觐� � 镳铌耔爨朦眍� � 滂耱嚯铎 皴沆屙蜞� 镥疱漤彘 龛聃钿�� 囵蝈痂� (贤�) � � 镳铌耔爨朦眍� � � 耩邃礤� 皴沆屙蜞� 钽栳帼� 囵蝈痂� (卫) 铖簌羼蜮脲磬 磬 箅疣玮箨钼铋 耔耱屐� VIVID 7 (GE Medical Systems). 理嚯桤桊钼嚯桉� 耠邃簋� 镱赅玎蝈腓: 桧蝈沭嚯 耜铕铖蜩 (FVI), 爨犟桁嚯�� (Vmax) � 耩邃��� 耜铕铖蜩 (Vmn) 镱蝾觐� � 觐痤磬痦 囵蝈痂�� � 镥痂钿� 耔耱铍� � 滂囫蝾臌. 冷尻忄蝽 潆� 疣聍弪� 镱蝾觇 � 贤� � 镳铌耔爨朦眍� � 滂耱嚯铎 皴沆屙蜞� 猁腓 镱塍麇睇 � 怦艴 犷朦睇� 檬滔 � � 镳嚓蜩麇耜� 玟铕钼 镟鲨屙蝾�.

体蝾潲 耱囹桉蜩麇耜钽� 囗嚯桤� 怅膻鬣腓 镳钼邃屙桢 钿眍羿牝铕眍泐 滂耧屦耔铐眍泐 � 觐痧咫�鲨铐眍泐 囗嚯桤钼. 骂 怦艴 镳铞邃箴圊 耱囹桉蜩麇耜钽� 囗嚯桤� 箴钼屙� 珥圜桁铖蜩 (p) 镳桧桁嚯�� 疣忭 0,05, 耦铗忮蝰蜮屙眍 漕忮痂蝈朦磬� 忮痤�蝽铖螯 (痄钼)=0,95. 绣珞朦蜞螓 镳邃耱噔脲睇 赅� M ± SD, 沅� �- 耩邃礤� 囵梏戾蜩麇耜铄, SD- 耩邃礤赈噤疣蜩黜铄 铗觌铐屙桢. 析屙赅 觐痧咫�鲨铐睇� 疋�珏� 戾驿� 镟疣扈 觐腓麇耱忮眄 镳桤磬觐� 铖簌羼蜮��豚顸 � 桉镱朦珙忄龛屐 礤镟疣戾蝠梓羼觐泐 疣磴钼钽� 觐翳鲨屙蜞 扬桊爨磬.

青疱汨耱痂痤忄� 拟篚羿珥 镳铘桦� 觐痤磬痦钽� 镱蝾赅 赅� � 犷朦睇� 檬滔, 蜞� � � 镳嚓蜩麇耜� 玟铕钼 腓�. 琼圜屙�� 桧蝈沭嚯� 耜铕铖蜩, 爨犟桁嚯铋 � 耩邃礤� 耜铕铖蝈� 镱蝾赅 � 镥痂钿 滂囫蝾臌 � 镳铌耔爨朦眍� 皴沆屙蝈 贤� 猁腓 耥桄屙� � 镟鲨屙蝾� 檬滔 镱 耩噔礤龛� � 觐眚痤脲� (FVI: 12,75±6,72 耢 vs 20,85±6,77耢; p<0,05; Vmax: 29,13 ±11,31 耢/� vs 52,20±7,04 耢/�; p<0,005; Vmn: 21,31±6,23 耢/� vs 35,40±2,79 耢/�; p<0,0050). � 滂耱嚯铎 皴沆屙蝈 贤� 珥圜屙�� 耜铕铖蝈� � 镥痂钿 耔耱铍� � 滂囫蝾臌 蜞� 驽 猁腓 耥桄屙� � 犷朦睇� 檬滔 镱 耩噔礤龛� � 镳嚓蜩麇耜� 玟铕钼� 漕狃钼铍囔�. � 3 (15%) 桤 20 镟鲨屙蝾� 檬滔 疱汨耱痂痤忄豚顸 疱忮瘃�� 耔耱铍梓羼觐泐 镱蝾赅 � 滂耱嚯铎 皴沆屙蝈 贤� � � 耩邃礤� 皴沆屙蝈 卫. 蒡� 蝠铄 镟鲨屙蝾� 铗腓鬣腓顸 铗 漯筱桴 镟鲨屙蝾� 檬滔 镱 蝾膣桧� 唐� (32,18±2,06 祆 vs 20,9±3,62 祆; �=0,005) � 烫似 (633,32±95,26 � vs 355,58±89,42 �; �=0,007). 项塍麇眄 磬扈 疱珞朦蜞螓 耦汶囫簋蝰� � 溧眄� 腓蝈疣蝮瘥 [3, 4], � 鬣耱眍耱� � 桉耠邃钼囗��扈 Crowley J. � 耦噔�. [3], 觐蝾瘥� 蜞� 驽 戾蝾漕� 蝠囗耱铕嚓嚯铋 蒗钍� 玎疱汨耱痂痤忄腓 疱忮瘃棹 耔耱铍梓羼觐泐 镱蝾赅 � 滂耱嚯铎 皴沆屙蝈 贤� � 3 桤 15 镟鲨屙蝾� 檬滔. 央邃箦� 铗戾蜩螯, 黩� Celik S c 耦噔�. [4] 怅膻麒腓 � 桉耠邃钼囗桢 犷朦睇� 蝾朦觐 � 钺耱痼牝桠眍� 纛痨铋 让侍� (耩邃礤� 珥圜屙桢 爨犟桁嚯钽� 沭噤桢眚� 戾驿� 似 - 囝痱铋 耦耱噔桦� 60±33 祆 痱. 耱.). � 铗腓麒� 铗 溧眄 腓蝈疣蝮瘥 � 铎 耦钺龛� 怙屦恹� 铞屙屙 漕镫屦钼耜栝 耧尻蝠 觐痤磬痦钽� 镱蝾赅 � 镳铌耔爨朦眍� � 滂耱嚯铎 皴沆屙蝈 贤� � � 耩邃礤� 皴沆屙蝈 卫 袜腓麒� 疱忮瘃梃 耔耱铍梓羼觐泐 镱蝾赅 礤 猁腩 忡噼祛疋�玎眄 � 沭噤桢眚铎 溧怆屙�� 似 - 囝痱�. 蒡� 溧弪 铖眍忄龛� 镳邃镱腩骅螯, 黩� 忮腓麒磬 沭噤桢眚� 钺耱痼牿梃 戾驿� 似 - 囝痱铋 礤 �怆�弪�� 漕扈龛痼桁 羿牝铕铎, 钺篑腩怆桠帼� 疱忮瘃棹 耔耱铍梓羼觐泐 镱蝾赅 � 滂耱嚯铎 皴沆屙蝈 贤� � � 卫. 篷腓 耥桄屙桢 腓礤轫铋 耜铕铖蜩 镱蝾赅 � 镥痂钿 滂囫蝾臌 � 镳铌耔爨朦眍� � 滂耱嚯铎 皴沆屙蜞� 贤� � � 卫 � 犷朦睇� 檬滔 祛骓� 疋�玎螯 � 镟蝾腩汨彘 爨臌� 桧蝠囔箴嚯 囵蝈痂�, 耥桄屙眍� 镱溧螂桠铖螯� 耱屙铌 桕囵滂嚯 囵蝈痂�, 蝾 沐礤� 疱忮瘃梃 耔耱铍梓羼觐泐 镱蝾赅 礤 �皴�. 填骓� 镱豚汔螯, 黩� 疱忮瘃�� 镱蝾赅 � 镥痂钿 耔耱铍� 祛驽� 猁螯 镳钽眍耱梓羼觇� 礤犭嚆铒痂�蝽 耔祜蝾祛�, 镱耜铍� 忭彗囡磬� 耢屦螯 猁豚 玎疱汨耱痂痤忄磬 � 溻篚 镟鲨屙蝾� � 疱忮瘃桢� 耔耱铍梓羼觐泐 镱蝾赅.

蔓忸潲.

1. � 犷朦睇� 檬滔 耥桄屙� 腓礤轫�� 耜铕铖螯 牮钼铗铌� � 镥痂钿 滂囫蝾臌 � 贤� � 卫.

2. � 15% 镟鲨屙蝾� 檬滔 疱汨耱痂痼弪�� 疱忮瘃�� 耔耱铍梓羼觐泐 镱蝾赅 � 滂耱嚯铎 皴沆屙蜞 贤� � � 耩邃礤� 皴沆屙蝈 卫.

3. 绣忮瘃�� 耔耱铍梓羼觐泐 镱蝾赅 � 滂耱嚯铎 皴沆屙蜞 贤� � 卫 礤 忡噼祛疋�玎磬 � 忮腓麒眍� 沭噤桢眚� 溧怆屙�� 似 - 囝痱�.

扬桉铌 腓蝈疣蝮瘥:

1. Maron B.J., Epstein S.E., Roberts W.C. Hypertrophic cardiomyopathy and transmural myocardial infarction without significant atherosclerosis of the extramural coronary arteries. // Am. J. Cardiol. - 1979. - Vol. 43. - P.1086-102.

2. Krzanowski M., Bodzon W., Dimitrow P.P. Imaging of all three coronary arteries by transthoracic echocardiography: an illustrated guide. // Cardiovascular Ultrasound. - 2003. - �1. - P. 1-16.

3. Crowley J.J., Dardas P.S., harcombe A.A., Shapiro L.M. Transthoracic Doppler chocardiographic analysis of phasic coronary blood flow velocity in hypertrophic cardiomyopathy. // Heart. - 1997. - Vol. 77. - P. 558-63.

4. Celik S., Dagdeviren B., Yidirim A., Gorgulu S., Uslu N., Eren M., Gurol T., Ozen E., Tezel T. determinants of Coronary Flow Abnormalities in obstructive Type Hypertrophic Cardiomyopathy: Noninvasive Assessment by Transthoracic Doppler Echocardiography. // J. Am.Soc. Echocardiogr. - 2004. - Vol. 17. - P. 744-9.