骨髓增殖性肿瘤患者心脏彩超研究结果探讨

目的 回顾性分析笔者医院骨髓增殖性肿瘤（myeloproliferative neoplasms，MPN）患者中经典的3种疾病即真性红细胞增多症（polycythemia vera，PV）、原发性血小板增多症（essential thrombocythemia，ET）、原发性骨髓纤维化（primay myelofibrosis，PMF）的临床特点及心脏彩超影像学表现，探索适合MPN患者的心血管合并症的早期预防及诊治模式。方法 选取2013年3月~2016年12月武汉大学中南医院血液内科住院且相关资料完善的初诊MPN患者43例，其中合并高血压的患者23例，作为A组，不合并高血压的患者20例，作为B组，选取同期健康体检者24例，作为C组对照。收集临床资料及心脏彩超相关结果，进行对比研究分析。结果 A、B、C 3组进行两两比较，显示左心室内径（left ventricular diameter，LV）、室间隔厚度（interventricular septum thickness，IVS）、左心室后壁厚度（left ventricular posterior wall thickness，LVPW）在3组中比较，差异有统计学意义（P<0.05），即MPN患者测得的心脏彩超的LV、IVS、LVPW数值较正常健康对照组高，且合并高血压的MPN患者较不合并高血压的MPN患者高。结论 MPN患者早期心脏彩超常表现为左心室肥大，合并高血压时进一步加重左心室肥大。通过心脏彩超检查能够了解MPN患者的心脏形态结构及功能，为患者的心血管合并症病情进展的早期预防及诊治提供客观依据。

Exploration on the Research Findings of Cardiac Ultrasonography in Patients With Myeloproliferative Neoplasms

Objective To retrospectively analyze the clinical features and echocardiographic results of three classical kinds of myeloproliferative neoplasms in our hospital which are polycythemia vera, essential thrombocythemia and primay myelofibrosis, and to explore prevention and treatment mode for patients with myeloproliferative neoplasms complicated with cardiovascular disease. Methods A total of 43 patients from March 2013 to December 2016 in the Hematology Department of Zhongnan Hospital of Wuhan University who have newly diagnosed myeloproliferative neoplasms with relatively completed data were selected, including 23 patients complicated with hypertension as group A and 20 patients without hypertension as group B. Meanwhile 24 healthy people in our hospital for physical examination were chosen as control group C. The clinical data and the results of echocardiography were collected to compare and analyze. Results The left ventricular diameter, interventricular septum thickness and left ventricular posterior wall thickness had significant differences in the three groups (P<0.05). That is, patients with myeloproliferative neoplasms measured by echocardiography were showed that left ventricular diameter, interventricular septum thickness and left ventricular posterior wall thickness parameters were higher than the normal healthy control group, and patients combined with myeloproliferative neoplasms and hypertension were higher than the former. Conclusion The early echocardiography findings of patients with myeloproliferative neoplasms showed that left ventricle became hypertrophic, and hypertension aggravated left ventricular hypertrophy. Through echocardiography test,we can understand the cardiac structure and function in patients with myeloproliferative neoplasms and provide an objective basis for early prevention and treatment for patients with cardiovascular complications of the disease.