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白血病是小儿造血系统最常见的恶性肿瘤,其特点为白血病细胞广泛而无控制地增生,除累及造血系统外还向全身各组织器官浸润,其中心血管系统的受累也比较常见。白血病并发心脏损害系多因素造成的,除自血病细胞浸润作用外,出血、贫血、化疗药物的作用、感染及代谢紊乱也是重要的因素。临床表现为心包积液、心电图示ST-T波改变、心律失常、心力衰竭等。但由于早期表现不明显,且常常缺乏特异性而易被临床医师忽略,部分白血病患儿因心脏损害导致死亡而非白血病本身所致。若能尽早预防、及时发现并针对性干预对提高白血病患儿的生存率是极为有益的。该文综述了近几年来国内外有关白血病患儿心脏损害的发生机制、诊断及防治方面的一些进展。
Leukemia is the most common malignant tumor in pediatric hematopoietic system. It is characterized by extensive and uncontrolled proliferation of leukemia cells. Involved in systemic tissues and organs in addition to the hematopoietic system, leukemia is more common in cardiovascular system. Leukemia and heart damage caused by multiple factors, in addition to leukemia cell infiltration, bleeding, anemia, the role of chemotherapy drugs, infection and metabolic disorders are also important factors. Clinical manifestations of pericardial effusion, ECG showed ST-T wave changes, arrhythmia, heart failure and so on. However, due to the early performance is not obvious, and often lack specificity and easily overlooked by clinicians, some children with leukemia due to heart damage caused by death rather than leukemia itself. If early prevention, timely detection and targeted interventions to improve the survival rate of children with leukemia is extremely useful. This review summarizes the recent advances in the pathogenesis, diagnosis and prevention of heart damage in children with leukemia in recent years.