结节病心脏损害80例临床分析

Cardiac involvement in sarcoidosis： a retrospective analysis of 80 sarcoidosis patients

目的观察结节病患者心脏受累的临床表现，分析结节病患者的性别、年龄、病程和分期与结节病心脏受累的相关关系。方法回顾分析我院80例结节病患者的临床资料。结果80例结节病患者中32例（40％）有心脏损害，其中5例（15．6％）有心脏相关症状。心脏损害包括心肌损害15例（46．9％），心电图检查ST—T异常8例（25％），心包积液6例（18．8％），心律失常5例（15．6％），肺动脉高压4例（12．5％），瓣膜病2例（6．3％），病理性Q波1例（3．1％）。心脏损害与无心脏损害患者间性别、病程和分期比较差异无统计学意义（P〉0．05），但两组的年龄比较有统计学意义（P〈0．05）。结论结节病可累及心脏各个部分，以心肌损害和心电图ST—T异常最常见。结节病累及心脏时多为无症状型。心脏损害与年龄相关。

Objective To observe cardiac manifestations in sarcoidosis and analyze the relationship between the cardiac abnormalities and the clinical characteristics of patients including sex, age, course of disease and chest radiographic stage of sarcoidosis. Methods The clinical data in 80 cases of sarcoido- sis admitted to Peking Union Medical College Hospital were reviewed. Results There were 32 （40.0%） cases with cardiac involvement in 80 patients and only 5 of them bad cardiac symptoms（ 15.6% ）. The manifestations were numerous,including myocardium lesions in 15 cases （46.9%）, ST segment and/or T wave（ST-T） ischemic changes of electrocardiography（ECG） in 8 cases （25.0%）, pericardial effusion in 6 cases （ 18.8% ）, arrhythmia in 5 cases （ 15.6% ）, pulmonary hypertension in 4 cases （ 12.5% ）, valve disease in 2 case（6.3% ） and pathologic Q wave of ECG in 1 case（3.1% ）. The patients with cardiac in- volvement had no significant differences（P 〉 0.05） in sex, course and chest radiographic stage of disease comparing to those who without, but had significant difference in age（P 〈 0.05 ）. Conclusions All components of the heart could be involved. Myocardium lesions and ST segment and/or T wave（ST-T） ischemic changes of ECG are most frequent among the cardiac manifestations. Most patients with cardiac lesions are asymptomatic. Cardiac involvement in sarcoidosis was related to the age.