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特发性脊柱侧凸患者心脏异常的发生率及危险因素。

Incidence and Risk Factors of Cardiac Abnormalities in Patients with Idiopathic Scoliosis.

机构信息

Department of Orthopaedics Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.

Department of Surgery, Beijing Changping Hospital, Beijing, China.

出版信息

World Neurosurg. 2019 May;125:e824-e828. doi: 10.1016/j.wneu.2019.01.177. Epub 2019 Feb 8.

Abstract

OBJECTIVE

We sought to investigate the incidence of cardiac abnormalities in patients with idiopathic scoliosis and identify risk factors related to cardiac abnormalities.

METHODS

A cohort of 531 patients with idiopathic scoliosis requiring surgical treatment in our hospital from March 2009 to August 2017 were recorded. Clinical data including medical records, radiograph, and echocardiogram were collected. All patients were divided into groups: control, congenital heart disease (CHD), and other cardiac abnormalities (OCAs). The incidence and related factors for cardiac abnormalities were analyzed.

RESULTS

The age of the study cohort was 17.8 ± 7.3 years. The average Cobb angle was 57.7 ± 16.5 degrees. Cardiac abnormalities were found in 149 (28.06%) patients, including 22 (4.14%) with CHD and 127 (23.92%) with OCAs. Atrial septal defect was the most common CHD with an incidence of 1.13% (6 of 531). Mitral valve prolapse was detected in 62 (11.68%) patients, which was the most prevalent OCA. Patients with CHD or OCAs weighed less as compared with patients without cardiac abnormalities. Low height was associated with CHD in patients with idiopathic scoliosis. Six patients with severe cardiac abnormalities must undergo cardiac intervention before scoliosis surgery.

CONCLUSIONS

The overall incidence of cardiac abnormalities was 28.81% in patients with idiopathic scoliosis. An echocardiogram may be helpful as a preoperative examination for patients with idiopathic scoliosis before scoliosis surgery.

摘要

目的

本研究旨在探讨特发性脊柱侧凸患者心脏异常的发生率,并确定与心脏异常相关的危险因素。

方法

本研究回顾性分析了 2009 年 3 月至 2017 年 8 月期间在我院接受手术治疗的 531 例特发性脊柱侧凸患者的临床资料。收集了包括病历、影像学和超声心动图在内的临床数据。所有患者分为对照组、先天性心脏病(CHD)组和其他心脏异常(OCAs)组。分析了心脏异常的发生率及相关因素。

结果

研究队列的平均年龄为 17.8±7.3 岁,平均 Cobb 角为 57.7±16.5°。149 例(28.06%)患者存在心脏异常,其中 22 例(4.14%)为 CHD,127 例(23.92%)为 OCAs。房间隔缺损是最常见的 CHD,发病率为 1.13%(6/531)。62 例(11.68%)患者存在二尖瓣脱垂,为最常见的 OCA。与无心脏异常的患者相比,CHD 或 OCAs 患者的体重较轻。特发性脊柱侧凸患者中,低身高与 CHD 相关。6 例严重心脏异常的患者在脊柱侧凸手术前必须进行心脏干预。

结论

特发性脊柱侧凸患者心脏异常的总体发生率为 28.81%。超声心动图可能有助于特发性脊柱侧凸患者在脊柱侧凸手术前进行术前检查。

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