摘要
目的:分析心脏黏液瘤患者心功能分级和栓塞发生情况及其与凝血功能的相关性。方法:采用回顾性研究,收集本院83例心脏黏液瘤患者的临床资料,记录患者主要临床症状,比较不同心功能分级的患者肿瘤最大径、血小板计数(PLT)、左心室射血分数(LVEF)、凝血酶原时间(PT)及纤维蛋白原(Fib)的差异,并比较发生下肢血管或脑栓塞患者与无栓塞患者肿瘤最大径、PLT、LVEF、PT及Fib的差异。 结果: 83例患者中,发生胸闷/胸痛18例(21.69%), 心悸/气促72例(86.75%),下肢水肿13例 (15.66%),全身乏力17例(20.48%);心脏听诊可闻及收缩期杂音22例(26.51%),闻及舒张期杂音29例(34.94%),双期杂音7例(8.43%);心功能分级以Ⅱ级为主,其中Ⅰ级11例(13.25%),Ⅱ级60例(72.29%),Ⅲ级8例(9.64%),Ⅳ级4例(4.82%)。超声心动图检查提示左心室黏液瘤9例(10.84%),右心房黏液瘤7例(8.43%),左心房黏液瘤71例(85.54%),心包积液10例(12.05%)。心电图检查提示窦性心律不齐5例(6.02%),ST-T段改变19例(22.89%),窦性心动过速7例(8.43%),左心房肥大2例(2.41%),右心房肥大1例(1.20%),心房颤动2例(2.41%)。随着心功能分级的升高,患者PT、Fib及PLT随之增高( P <0.05),而不同心功能分级患者肿瘤最大径和LVEF比较,并无明显差异( P >0.05)。83例患者中,9例(10.84%)出现下肢血管或脑栓塞,此类患者PT、Fib及PLT较无栓塞者明显升高( P <0.05),而肿瘤最大径和LVEF与无栓塞者比较,并无明显差异( P >0.05)。 结论: 心脏黏液瘤患者心功能分级以Ⅱ级为主,部分患者可出现下肢血管或脑栓塞,且患者心功能分级与栓塞的发生与凝血功能关系密切。
Objective:To analyze the classification of cardiac function and the occurrence of embolism in patients with cardiac myxoma and its correlation with coagulation function.Methods:A retrospective study was conducted to collect the clinical data of 83 patients with cardiac myxoma in our hospital.The main clinical symptoms were recorded.The differences of tumor maximum diameter,platelet count(PLT),left ventricular ejection fraction(LVEF),prothrombin time(PT)and fibrinogen(Fib)in patients with different cardiac function grades were compared,and the patients with lower extremity vascular or cerebral embolism were compared.The difference of the maximum diameter,PLT,LVEF,PT and Fib of the tumors between the patients without embolism and the patients without embolism was analysed.Results:Among 83 patients,there were 18 cases(21.69%)of chest tightness/chest pain,72 cases(86.75%)of palpitation/shortness of breath,13 cases(15.66%)of edema of lower extremities,17 cases(20.48%)of general fatigue,22 cases(26.51%)of tumour falls during auscultation,29 cases(34.94%)of systolic and diastolic murmurs,and 7 cases(8.43%)of biphasic murmurs.Cardiac function was mainly classified as grade II.Among them,there were 11 cases(13.25%)of grade I,60 cases(72.29%)of grade II,8 cases(9.64%)of grade III and 4 cases(4.82%)of grade IV.Echocardiography revealed 9 cases of left ventricular myxoma(10.84%),7 cases of right atrial myxoma(8.43%),71 cases of left atrial myxoma(85.54%)and 10 cases of pericardial effusion(12.05%).ECG examination showed sinus arrhythmia in 5 cases(6.02%),ST-T segment changes in 19 cases(22.89%),sinus tachycardia in 7 cases(8.43%),left atrial hypertrophy in 2 cases(2.41%),right atrial hypertrophy in 1 case(1.20%)and atrial fibrillation in 2 cases(2.41%).PT,Fib and PLT increased with the increase of cardiac function grading(P<0.05),but there was no significant difference between the maximum diameter of tumors and LVEF in patients with different cardiac function grading(P>0.05).Among 83 patients,9(10.84%)had lower extremity vas
作者
史帅涛
王国权
李晓健
韩文豪
翟水亭
Shi Shuaitao;Wang Guoquan;Li Xiaojian;Han Wenhao;Zhai Shuiting(Department of Vascular Surgery,Fuwai Central China Cardiovascular Hospital,Henan Zhengzhou 450000,China;Department of Vascular Surgery,Henan People's Hospital,Henan Zhengzhou 450000,China.)
出处
《现代肿瘤医学》
CAS
2020年第2期240-243,共4页
Journal of Modern Oncology
基金
2018年度河南省医学科技攻关计划项目(编号:2018020440)
关键词
心脏黏液瘤
栓塞
心功能分级
凝血功能
相关性
cardiac myxoma
embolism
cardiac function classification
coagulation function
correlation
