Végh Judit, Vadász Györgyi, Miltényi Zsófia, Soltész Pál, Tizedes Franciska, Illés Arpád
Debreceni Egyetem Orvos- és Egészségtudományi Centrum, III. sz. Belgyógyászati Klinika, Hungary.
Magy Onkol. 2002;46(4):357-60. Epub 2003 Feb 1.
To study the occurrence of valvulopathies after treatment in Hodgkin's disease patients.
124 Hodgkin's disease patients in complete remission for at least 1 year were echocardiographically examined.
Abnormal finding was observed in 48/124 (38.4%) of patients, all of them presented with regurgitation, no stenosis was observed. Regurgitation of grade I or II was recorded in most cases. We have found single valvulopathy in 25/48 (52.1%) of patients, and multiple valvulopathy in 23/48 (47.9%) of patients. In most cases (78.7%) the valvulopathy was detected in left heart. Among these 48 patients the ratio of females was significantly higher than those of males, and also the ratio of the patients in early phase compared with those in late phase. We could detect vitium mostly in those patients who had mediastinal irradiation. The combined treatment, including anthracycline therapy, did not increase the frequency of vitium.
The occurrence of valvulopathy is frequent in Hodgkin's disease patients, particularly in patients treated by radiation. This is the reason why Hodgkin's disease patients should be examined regularly with echocardiography. These patients with valvulopathy need treatment adjusted to their state of health, and where possible, the complications should be prevented. In the future, when planning of the radiotherapy mediastinal irradiation of the Hodgkin's disease patients their heart protection from radiation should be taken into account.
研究霍奇金病患者治疗后瓣膜病的发生情况。
对124例完全缓解至少1年的霍奇金病患者进行超声心动图检查。
124例患者中有48例（38.4%）观察到异常发现，所有患者均表现为反流，未观察到狭窄。大多数病例记录为I级或II级反流。我们发现25/48（52.1%）的患者存在单一瓣膜病，23/48（47.9%）的患者存在多种瓣膜病。在大多数情况下（78.7%），瓣膜病在左心被检测到。在这48例患者中，女性比例显著高于男性，早期患者的比例也高于晚期患者。我们大多能在接受纵隔放疗的患者中检测到瓣膜病变。包括蒽环类药物治疗在内的联合治疗并未增加瓣膜病变的发生率。
霍奇金病患者中瓣膜病的发生很常见，尤其是接受放疗的患者。这就是为什么霍奇金病患者应定期进行超声心动图检查的原因。这些患有瓣膜病的患者需要根据其健康状况进行治疗，并尽可能预防并发症。未来，在规划霍奇金病患者的纵隔放疗时，应考虑对其心脏进行放射防护。
