白血病患者心脏损害的研究

目的：探讨白血病患者心脏损害早期的客观依据。方法：对40例白血病患者、27例贫血患者和24例正常人做心电学、心脏形态、功能及酶学检测。结果：VCG检测显示白血病横面QRS环最大向量振幅、额面及横面R／T均高于正常对照组；与正常对照组比较，白血病组额面ST方位向右上移位、T环最大向量方位向左移位。UCG检测显示处于贫血状态的初治白血病组与正常对照组比较，LVEF、LVFS无显著差异，但白血病组的A和A／E高于正常对照组、EF斜率低于正常对照组。结论：仅以ECG和胸片作为白血病患者心脏状况的监测手段有很大的局限性。白血病患者心脏损害早期在VCG及UCG上表现为左室舒张功能不全，推测可能与白血病细胞对心脏的侵润及白血病微循环障碍等原因有关。

STUDY OF THE CARDIAC DAMAGE IN PATIENTS WITH LEUKEMIA

Objective:To investigate the objective evidence of early cardiac damage in leukemia patients.Methods:The methods of cardiac electrophysiology,cardiac morphology,myocardial enzymology and the method of cardiac function were performed in 40 leukemia patients,27 anemia patients and 24 healthy subjects.Results:(1)The results of vectorcardiogram showed that the magitude of maximum QRS vector in Harizantal plane and the R/T in Frontal and Sagittal planes were greater in leukemia patients than in the normal group;compared with those in normal group,the direction of the ST vector in Fronal plane displaced to the superiorly right,the direction of maximum T vector in Frontal plane displaced to the left.(2)The results of echocardiagram showed that there were not significant difference in LVEF,LVFS between normal subjects and leukemia patients who had not been treated and were in anemic condition,but compared with those in normal controls,both A peak velocity (A) and A/F in leukemia patients were high and EF slope was low.Conclusion:(1)It is very limited to only use the electrocardiogram and the chest radiograph as the means of moniting cardiac condition in leukemia patients.(2) The early cardiac damage displayed in vectorcardiogram and echocardiogram show the diastolic dysfunction of left ventricular,we infer that it may be concered with the leukemic infiltration of heart and the dysfunction of microcirculation associated with leukemia.