8例多发性骨髓瘤致心肌淀粉样变性临床特点分析  

Clinical characteristics of 8 patients with cardiac amyloidosis caused by multiple myeloma

作　　者：邱惠[1] 沈爱东[1] 孙志军[1] 李虹伟[1] Qiu Hui;Shen Aidong;Sun Zhijun;Li Hongwei(Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)

机构地区：[1]首都医科大学附属北京友谊医院心内科,100050

出　　处：《中国心血管杂志》2018年第3期219-223,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨多发性骨髓瘤致心肌淀粉样变性患者的临床特征。方法收集2009—2017年首都医科大学附属北京友谊医院收治的8例多发性骨髓瘤导致心肌淀粉样变性患者,分析其临床资料。结果多发性骨髓瘤致心肌淀粉样变性患者常伴心功能不全,且合并心血管系统以外的临床表现。同时出现心电图肢体导联低电压和超声心电图左心室壁增厚是心肌淀粉样变性的特征改变。心脏磁共振成像呈钆延迟显像,临床高度提示心肌淀粉样变性。病理活组织检查可确定诊断。结论心外组织活检结合临床表现、心电图、超声心电图及心脏磁共振成像可确诊心肌淀粉样变性,但此类患者因临床缺乏有效治疗手段,预后较差。Objective To study the clinical characteristics of patients with cardiac amyloidosis（CA） caused by multiple myeloma. Methods Methods In this paper,8 patients with myocardial amyloidosis caused by multiple myeloma were collected,who were admitted to Beijing Friendship Hospital,Capital Medical University from 2009 to 2017. The clinical characteristics of CA patients were analyzed.Results Clinical manifestations of patients with myocardial myeloma caused by multiple myeloma are diversified,often have cardiac insufficiency and have clinical manifestations outside of the cardiovascular system. Low voltage in limb lead and hypertrophy in left ventricular are the characteristic changes of CA. Cardiac magnetic resonance imaging（MRI） presented gadolinium delay imaging,which has high positive rate in diagnosis of CA. The golden standard for diagnosis of CA is the positive of Congo Red stain in endomyocardial biopsy. Conclusions CA diagnosis can be confirmed by biopsy of exocardial tissue in combination with electrocardiograph,ultrasonic cardiogram and MRI. The progression is different of CA,but generally with poor prognosis due to lack of effective treatment.

关 键 词：淀粉样变性 多发性骨髓瘤 疾病特征 

分 类 号：R733.3[医药卫生—肿瘤]