嗜酸性粒细胞增多综合征所致心脏损害的超声心动图特征分析

Echocardiographic features of cardiac damage caused by hypereosinophilic syndrome

目的嗜酸性粒细胞增多综合征可以累及几乎全身所有组织器官,心脏是最常受累的器官,也是引起患者死亡的最重要原因。本研究通过总结嗜酸性粒细胞增多综合征患者心脏损害的临床及超声表现,为早期发现、正确诊断以便及时治疗提供准确可行的手段。方法回顾性分析西安交通大学第一附属医院心内科2004年至2014年诊断的5例嗜酸性粒细胞增多综合征患者的临床及超声心动图表现,探寻其共性及特异性表现。结果 5例患者中有4例为特发性嗜酸性粒细胞增多综合征,另1例为寄生虫感染后的继发性嗜酸性粒细胞增多综合征。超声心动图表现为心房扩大5例,其中4例为双房扩大,2例同时伴有心室扩大;5例患者均出现心内膜增厚伴血栓形成,4例为双心腔心尖部血栓,1例血栓仅出现于左室心尖部。超声心动图同时观察到瓣膜、心包的变化,均可能是本病特征性超声表现。结论嗜酸性粒细胞增多综合征所致心脏损害是该病患者死亡的主要原因,超声心动图可以准确发现这些特征性改变,为临床早期发现以便及时、正确治疗提供帮助。

Objective Hypereosinophilic syndrome(HES)is a hematological disorder that may involve multiple organs,especially the heart as the targeting organ,and is the most important cause of death among patients.This paper summarizes the clinical and echocardiographic results of patients diagnosed with HES so as to provide an accurate and feasible method for early detection and timely treatment of the disease.Methods We retrospectively analyzed the clinical data of five HES patients who came to the Department of Cardiology,Xi..an Jiaotong University,from 2004 to 2014 with the purpose of finding out the common and specific manifestations in transthoracic echo imaging.Results There were five patients diagnosed with HES,with four cases of idiopathic HES and one of secondary HES after parasitic infection.Atrial enlargement was detected in the five patients,including four cases with double atria expansion and two cases with ventricular dilatation.Endocardial thickening was observed in all the patients with thrombosis,including four cases of thrombus detected in the double chambers..apex of and one case of thrombus only in the left ventricular apex.Changes of the valves and the pericardium were also shown in the transthoracic echocardiographic images and might be the characteristic features.Conclusion Cardiac damage caused by HES is the main cause of death in the patients.Echocardiography can accurately show characteristic changes and provide help for early detection and correct treatment.