心脏粘液瘤临床表现及术前发生血管栓塞的危险因素分析

Clinical Manifestations of Patients with Cardiac Myxoma and Risk Factors for Vascular Embolism Before Surgery

目的探讨心脏粘液瘤临床表现,并分析患者术前发生血管栓塞的危险因素。方法回顾性分析行手术治疗的75例心脏粘液瘤患者的资料,分析其临床表现,单因素及多因素Logistic回归分析影响患者术前发生血管栓塞的危险因素。结果75例心脏粘液瘤患者入院时以呼吸困难(66.67%)、心悸(46.67%)为主要临床表现,其次为栓塞(29.33%),心功能分级主要为Ⅰ~Ⅱ级(68.00%),Ⅲ~Ⅳ级占比仅为32.00%。单因素分析显示,是否合并栓塞组间年龄、吸烟史、心房颤动占比、肿瘤结构、形态及活动度等比较具有明显差异(P<0.05);将单因素具有差异的因素纳入行多因素Logistic回归分析显示,年龄较小、吸烟史、心房颤动、肿瘤疏松结构、不规则形态均为影响心脏粘液瘤患者并发栓塞的危险因素(P<0.05)。结论心脏粘液瘤主要表现为呼吸困难、心悸及栓塞,年龄、吸烟史、心房颤动、肿瘤结构和形态均为影响心脏粘液瘤患者并发栓塞的危险因素。

Objective To investigate the clinical manifestations of cardiac myxoma patients and to analyze the risk factors of vascular embolism before surgery.Methods The data of 75 patients with cardiac myxoma who underwent surgical treatment were analyzed retrospectively,the clinical manifestations were analyzed,and the risk factors of preoperative vascular embolism were analyzed by univariate and multivariate Logistic regression.Results Among the 75 patients with cardiac myxoma who were admitted to the hospital,dyspnea(66.67%)and palpitations(46.67%)were the main clinical manifestations,followed by embolism(29.33%),and the grade of cardiac function was mainly grade I-II(68.00%),and grade III-IV accounted for less,only 32.00%.Univariate analysis of patient data was shown that there were significant differences in age,smoking history,proportion of atrial fibrillation,tumor structure,morphology and mobility between embolization groups(P<0.05).Multivariate logistic regression analysis showed that younger age,smoking history,atrial fibrillation,loose structure of tumors,and irregular morphology were all risk factors affecting embolism in patients with cardiac myxoma(P<0.05).Conclusion The main manifestations of cardiac myxoma are dyspnea,palpitation and embolism.Age,smoking history,atrial fibrillation,tumor structure and morphology are all risk factors for cardiac myxoma patients complicated with embolism.