Durongpisitkul Kritvikrom, Kruasukon Siwiluck, Kangkagate Charuwan, Tanphaichitr Voravarn S
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2002 Aug;85 Suppl 2:S667-73.
Beta-thalassemia major and beta-thalassemia/HbE are the important causes of chronic hemolytic anemia in Thailand. The objectives of the study were to determine variables associated with cardiac involvement in asymptomatic beta-thalassemia patients.
The authors studied beta-thalassemia major and beta-thalassemia/HbE patients who came to the clinic between July 1st 1999 and July 31st 2000. There were 211 asymptomatic patients included in study. Their ages ranged from 2.6 to 18.2 years. Previous clinical history including blood transfusion and iron chelation were recorded. All patients received a thorough physical examination, chest X-ray, electrocardiogram and echocardiogram. Patients who had abnormal systolic or diastolic function detected by echocardiogram were identified as having cardiac involvement.
Cardiac involvement was found in 26 patients (12.3%). There was no difference in physical examination between patients who had and did not have cardiac involvement. Abnormal chest X-Ray defined as cardiothoracic (CT) ratio>0.55 and electrocardiogram (ECG) findings of left or right ventricular hypertrophy were associated with cardiac involvement. Other associated findings were older age and lower average pretransfusion hematocrit (23 +/- 6.6%).
In asymptomatic beta-thalassemia children, chest X-ray and ECG should be used for screening patients for the detection of cardiac involvement.
重型β地中海贫血和β地中海贫血/HbE是泰国慢性溶血性贫血的重要病因。本研究的目的是确定无症状β地中海贫血患者心脏受累的相关变量。
作者研究了1999年7月1日至2000年7月31日期间到诊所就诊的重型β地中海贫血和β地中海贫血/HbE患者。共有211例无症状患者纳入研究。他们的年龄在2.6至18.2岁之间。记录既往临床病史，包括输血和铁螯合治疗情况。所有患者均接受了全面的体格检查、胸部X线检查、心电图检查和超声心动图检查。超声心动图检测到收缩或舒张功能异常的患者被确定为有心脏受累。
26例患者（12.3%）存在心脏受累。有心脏受累和无心脏受累的患者在体格检查方面无差异。胸部X线异常定义为心胸比（CT）>0.55以及心电图显示左心室或右心室肥大与心脏受累相关。其他相关发现为年龄较大和输血前平均血细胞比容较低（23±6.6%）。
对于无症状的β地中海贫血儿童，应使用胸部X线和心电图来筛查心脏受累患者。
