真性红细胞增多症患者心脏相关指标改变的临床分析  

Changes of heart-related indexes in patients with polycythemia vera

作　　者：康虹阳 刘洁[1] 陈哲[1] 佟长青[1] 吉慧姝 李琦[1] 张斌[2] KANG Hongyang;LIU Jie;CHEN Zhe;TONG Changqing;JI Huishu;LI Qi;ZHANG Bin(Department of Hematology,The First Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075000,China;不详)

机构地区：[1]河北北方学院附属第一医院血液科,河北张家口075000 [2]河北北方学院附属第一医院检验科,河北张家口075000

出　　处：《空军医学杂志》2022年第2期143-145,183,共4页Medical Journal of Air Force

基　　金：河北省医学科学研究重点项目(20170811)。

摘　　要：目的分析真性红细胞增多症患者心脏相关指标的特点,并探讨其临床意义。方法选取2019年1月—2021年12月于河北北方学院附属第一医院接受治疗的真红患者56例为观察组,健康体检者30例为对照组。将观察组分为高血压组(26例)和非高血压组(30例)。对比各组血液指标及心脏超声指标。结果非高血压组在血红蛋白(hemoglobin,HGB)浓度、红细胞压积(hematokrit,HCT)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)、肌红蛋白(myoglobin,Mb)、室间隔厚度(interventricular septum thickness,IVSTd)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、二尖瓣舒张早期与舒张晚期最大血流速度之比(the ratio of early diastolic to late diastolic mitral inflow velocity,E/A),与对照组比较,差异有统计学意义,高血压组在HGB、HCT、LDH、CK、Mb、左房径(left atrial diameter,LAD)、IVSTd、LVEDD、左心室射血分数(LVEF)、E/A与非高血压组比较,差异有统计学意义。观察组中LDH、CK、Mb、LAD、IVSTd、LVEDD分别与HGB、HCT呈正相关,LVEF、E/A与HGB、HCT呈负相关。结论真红患者早期存在心肌损伤、左心室肥厚及左室舒张功能减退等改变,合并高血压者更明显。考虑与红细胞容量增加引起的血流动力学改变有关。Objective To analyze the characteristics of heart-related indexes in patients with polycythemia vera(PV).Methods Fifty-six cases of PV patients were selected as the observation group while another 30 healthy subjects served as thecontrol group.The observation group was divided into the hypertensive group(26 cases)and non-hypertensive group(30cases).Blood indexes and echocardiographic indexes of each group were compared.Results There was significant difference in concentrations of hemoglobin(HGB),hematokrit(HCT),lactate dehydrogenase(LDH),creatine kinase(CK),myoglobin(Mb),interventricular septum thickness(IVSTd),left ventricular end-diastolic diameter(LVEDD)and the ratio of early diastolic to latediastolic mitral inf low velocity(E/A)between the hypertensive group and the control group,or between the hypertensive group and the non-hypertensive group in terms of HGB,HCT,LDH,CK,Mb,left atrial diameter(LAD),IVSTd,LVEDD,left ventricular ejection fraction(LVEF)and E/A.In the observation group,levels of LDH,CK,Mb,LAD,IVSTd and LVEDD were positively correlated with HGB and HCT,while those of LVEF and E/A were negatively correlated.Conclusion There is myocardial injury,left ventricular hypertrophy and left ventricular diastolic dysfunction in patients with PV,especially inthose with hypertension,which is possibly associated with hemodynamic changes caused by the increased erythrocyte volume.

关 键 词：真性红细胞增多症 心肌损伤 心脏超声 心脏结构 心脏功能 

分 类 号：R552[医药卫生—血液循环系统疾病]