心脏黏液瘤并发卒中12例分析  

Cardiac myxoma with cerebral embolism——analysis of 12 cases

作　　者：霍本良[1] 蒋杞英[2] 李月娟[3] 时雅辉 赵建华[3] 

机构地区：[1]开封市第二人民医院心内科,河南开封475002 [2]河南大学医学院组胚教研室,河南开封475004 [3]河南省人民医院神经内科,河南郑州450003

出　　处：《临床荟萃》2015年第7期758-761,共4页Clinical Focus

基　　金：河南省卫生厅科技计划资助项目(20083106);河南省科技厅科技计划资助项目(132300410425)

摘　　要：目的探讨心脏黏液瘤并发脑栓塞的临床和影像学特点。方法对12例心脏黏液瘤并发脑栓塞病例的性别、年龄、临床表现、超声心动图及影像学特点等进行回顾性分析。结果男3例,女9例;年龄11-59岁,中位年龄29.1岁。左心房黏液瘤10例,右心房黏液瘤1例,左心房黏液瘤1例。黏液瘤伴出血3例。右侧肢体瘫痪7例,其中伴失语3例;左侧肢体瘫痪2例;眩晕伴心慌、胸闷2例;双眼视野缺损1例。黏液瘤蒂附着于卵圆窝处7例,房间隔3例,二尖瓣处2例。MRI显示均为多发脑栓塞,左侧大脑半球梗死7例,右侧大脑半球梗死2例,双侧大脑半球梗死1例,小脑和脑干梗死2例。前循环脑梗死10例,后循环脑梗死2例。结论心脏黏液瘤为最常见的心脏良性肿瘤,左心房黏液瘤最常见;任何年龄均可发病,以青年女性多见,临床表现复杂多变,脑栓塞为其常见并发症,是青年卒中的重要原因。Objective To explore the clinical and imaging features of cardiac myxoma with cerebral embolism.Methods A total of 12 patients were retrospectively investigated about gender,age,clinical presentations,echocardiographic and neurologic-imaging features.Results The range age at admission of 12 cases was 11-59years（median 29.1years,3males and 9females）.There were 10 cases with left atrial myxoma,followed one case by the right atrial myxoma and left ventricular myxoma respectively;myxoma with hemorrhage was involved in 3cases.The right physical hemiparalysis was in 7cases,including 3cases of aphasia,2cases of left physical hemiparalysis,2cases of dizziness,associated with palpitation and chest tightness,1case with binocular visual field defects.The pedicle of myxoma attached to the oval fossa in 7cases,3cases of atrial septal and mitral valve at 2cases.Brain magnetic resonance imaging（MRI）of all cases showed multiple embolisms.Two cases showed both sides cerebral infarction,1case located in cerebellum and the other of brainstem infarction.The occlusion site of 7 cases located in left hemisphere,another 2cases in right hemisphere and the last one in bilateral hemisphere.Ten out of 12 cases with anterior circulation infarctions.Two out of 12 cases with posterior circulation infarction.Conclusion Cardiac myxoma is the most common benign neoplasm of heart,it most commonly originate in the left atrium.The disease may be diagnosed in any age of life and the youth females prone to suffer from.The clinical presentations are complex and changeable,moreover,the cerebral embolism is a common complication.Cardiac myxoma is an important cause in youth cerebral embolism.

关 键 词：心脏黏液瘤 脑栓塞 超声心动图 

分 类 号：R541[医药卫生—心血管疾病]