老年甲状腺功能减退症合并冠心病临床研究

Clinical Study in Elderly Hypothyroidism with Coronary Heart Disease

目的探讨老年甲状腺功能减退症(甲减)合并冠状动脉粥样硬化性心脏病(冠心病)的临床特点。方法回顾性分析我院住院治疗的32例老年甲减合并冠心病(甲减组)患者的临床资料,根据临床上粘液性水肿、怕冷、少汗、脱发等症状、甲状腺功能、心电图等结果进行分析,并与同期收治的老年性非甲减性冠心病(对照组)32例进行比较。结果两组病例均用抗凝、降脂、扩冠等常规治疗,甲减组另加用甲状腺素替代治疗,小剂量开始,逐渐加至需要量,疗程4～8周,经上述治疗,两组心电图缺血改善,血脂下降,P>0.05,无显著性差异,甲减组固有的特点,如粘液性水肿、怕冷、少汗、贫血等改善,心率增快,甲状腺功能恢复至正常低值以上,与对照组比较,P<0.01,有显著性差异。结论对老年甲减合并冠心病患者,其临床特征较非甲减组冠心病有不同,除心电图改变、血脂升高的共同特征外,甲减组尚有粘液性水肿、怕冷、少汗、脱发、便秘、贫血、甲状腺功能减低等。反之,对老年冠心病患者出现上述甲减症状,要查甲状腺功能,以免漏诊,发现甲减要用甲状腺素替代治疗。

Objective To investigate the clinical characteristics of the elderly hypothyroidism with coronary heart disease. Methods To anal- yse 32 cases of elderly hypothyroidism with coronary heart disease in our hospital, according to looking back ways. To analyse the results of the myxedema, feeling of cold, lowing- sweat, anemia, the function of thyroid, electrocardiogram.To compare 32 cases elderly non- hypothyroidism with coronary heart disease.Results Using the nonnaling treatments of the anti - condensation.declining the hyperlipidemia, expanding the corona arteries in two groups, adding the thyroxine in hypothyroidism groups, Beginning from low dosage, adding to the demand dosage gradually, 4-8 weeks of treatments. In two groups, through the above- mentioned treatments, the myocardial ischemia had been improved, the hyperlipidemia had been declined, P 〉 0.05, there were not significant differences in two groups.In the hypothyroidism group, the characteristics had been improved, such as myxedema, feeling of cold, lowing- sweat, alopeda, The function of thyroid and heart rate had been improved. To compare with matched control, there were significant difference P 〈 0.01.Conclusion There are differences in elderly hypothyroidism with coronary heart disease and elderly non- hypothyroidism with coronary heart disease.In elderly hypothyroidism group, addition to the characteristics of electrocardiogram and hyperlipidemia, there are also myxedema, feeling of cold, lowing - sweat, alopeda. hypothyroidism.Whereas, to the elderly coronary heart disease patients, ff there is hypothyroidism symptoms, we should check the function of thyroid. If finding hypothyroidism, we should treat the patients with thyroxine.