目的观察重型β地中海贫血(TM)患者心脏房室扩大情况及其危险因素。方法对57例TM患者以心脏彩超测量其心脏房室大小,并记录一般情况、输血和去铁状况,测量血清铁蛋白浓度。结果 57例患者中19例有心房和(或)心室扩大。左心房、右心房、左心室、右心室扩大分别为14例(24.6%)、14例(24.6%)、10例(17.5%)、7例(12.3%)。相关分析表明,输血前血红蛋白浓度是影响心脏房室扩大的唯一独立因素。结论 TM患者中心脏房室改变较为普遍,需加强规范化输血治疗以维持输血前血红蛋白大于90 g/L。
Objective To investigate the risk factors of ventricular and atrial enlargement in beta Thalassemia Major(TM) patients. Methods From July 2008 to March 2010,doppler dchocardiography were performed on 57 patients with TM.General condition,blood transfusion data,iron chelator usage and serum ferritin were recorded. Results Among 57 patients,enlargement in ventricular and/or atrium was revealed in 19 patients.Enlargements of left atrium,right atrium,left ventricular and right ventricular accounted for 24.6,24.6,7.5 and 12.3%,respectively.Hemoglobin level before blood transfusion was proved to be the only independent risk factor affecting the enlargement of heart. Conclusion Heart enlargement is common in TM patients.Standardized blood transfusion should be intensified to keep hemoglobin level higher than 90 g/L.