Wu Xingli, Yang Dingyou, Yang Zhongsu, Li Jiayue, Zhao Yusheng, Wang Ke, Zhang Ran
Institute of Geriatric Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
EXCLI J. 2012 May 22;11:240-9. eCollection 2012.
Myxoma is the most common type of primary cardiac neoplasm, but the clinical characteristics and long term outcome are less known in the elderly in China.
We analyzed medical records of 112 consecutive patients who underwent operative resection of cardiac myxoma between December 1988 and December 2010 in our hospital. Their data were retrospectively analyzed and the difference between two age groups (< 60 years, n = 87 and ≥ 60 years, n = 25) was compared.
The mean age of 112 patients was 48.8 ± 12.5 (range 13 ~ 75) years, and 66 patients (58.9 %) were female. The interval from onset of symptoms to diagnosis was 12 months and the most common presenting symptoms were chest distress (66 patients 58.9 %), followed by palpitations (55 patients, 49.1 %) and dyspnea (47 patients, 42.0 %). Mitral valve diastolic murmur was heard in 67 (59.1 %) patients. The tumor was located in the left atrium in 96 (85.8 %) patients. There were no in-hospital death. During follow-up ranged between one and twenty-one (7.3 ± 5.3) years, there was no malignancy. Myxoma recurred in 3 (2.7 %) patients and deaths occurred in 5 (4.5 %) patients. The 5 and 15 years survival was 97.8 % and 89.5 %, respectively. To compare with the younger patients, the elderly have higher ratios of concomitant hypertension, fewer complaints of dyspnea and chest distress (p < 0.05).
The elderly have lower complaints of dyspnea and chest distress, surgical treatment is associated with low long-term mortality and recurrence rate even in the elder patients.
黏液瘤是最常见的原发性心脏肿瘤类型，但在中国老年人中其临床特征和长期预后鲜为人知。
我们分析了1988年12月至2010年12月期间在我院连续接受心脏黏液瘤手术切除的112例患者的病历。对他们的数据进行回顾性分析，并比较两个年龄组（<60岁，n = 87；≥60岁，n = 25）之间的差异。
112例患者的平均年龄为48.8±12.5（范围13~75）岁，66例（58.9%）为女性。从症状出现到诊断的间隔时间为12个月，最常见的症状是胸闷（66例，58.9%），其次是心悸（55例，49.1%）和呼吸困难（47例，42.0%）。67例（59.1%）患者可闻及二尖瓣舒张期杂音。96例（85.8%）患者的肿瘤位于左心房。无住院死亡病例。在为期1至21（7.3±5.3）年的随访期间，无恶性肿瘤发生。3例（2.7%）患者黏液瘤复发，5例（4.5%）患者死亡。5年和15年生存率分别为97.8%和89.5%。与年轻患者相比，老年人合并高血压的比例更高，呼吸困难和胸闷的主诉较少（p<0.05）。
老年人呼吸困难和胸闷的主诉较少，即使是老年患者，手术治疗的长期死亡率和复发率也较低。
