伴肌酸激酶升高的甲状腺功能减退症和急性心肌梗死的对比分析

A contrasting study on hypoparathyroidism and acute myocardial infarction both accompanied by creatine kinase's uprising

目的对比分析伴有肌酸激酶升高的甲状腺功能减退症和急性心肌梗死的临床特点,为鉴别诊断提供帮助。方法对15例甲状腺功能减退症伴肌酸激酶升高患者及33例急性心肌梗死患者进行了回顾性对比分析。结果伴肌酸激酶升高的甲状腺功能减退症主要发生于中年人,以女性为主,而急性心肌梗死主要好发于老年人,本组资料中男女发病率相近(P<0.05);与后者相比,前者合并高血压病更少(P<0.01),胸痛/胸闷症状更少(P<0.05),脉搏相对更慢(P<0.01),贫血(P<0.01)和浮肿(P<0.01)的发生率更高,血脂以胆固醇升高更明显(P<0.05),心包积液发生率更高(P<0.01),发生左室舒张功能降低更少(P<0.05)。结论甲状腺功能减退症的临床表现高度多样化,与急性心肌梗死在治疗和预后方面有显著不同。

Objective To contrast the clinical characteristics of hypoparathyroidism and acute myocardial infarction both accompanied by creatine kinase＇ s uprising in order to give help for discrimination. Methods 15 cases with hypoparathyrodism and 33 cases with acute myocardial infarction, both accompanied by creatine kinase＇ s uprising, were reviewed critically and retrospectively. Results Hypothyroidism with creatine idnase＇ s uprising often occun＇ed in the middle age, females more than males while acute myocardial infarction often occurred in the older with similar morbidity in both sexes （P 〈 0.05） ; Compare with the latter, the occurrence of the incorporative high blood pressure disease of the former was less （ P 〈 0.01 ）, the chest pain/chest stuffiness was less （ P 〈 0.05 ）, and the pulse was more slowly （ P 〈 0.01 ） , the occurrence rate of anemia （ P 〈 0.01 ） and edema （ P 〈 0. 01 ） was higher, the uprising of cholesterol was more obvious （ P 〈 0.05 ）, the occurrence of pericardial effusion was more often （ P 〈 0.01 ）, and the decreasing of the left ventricular diastolic function was less （P 〈 0.05）. Conclusion The clinical performances of hypothyroidism is variegated. There were obvious differences in treatment and prognosis between hypoparathyroidism and acute myocardial infarction.