甲状腺功能亢进性心脏病75例临床分析

Clinical features of thyrotoxic heart disease:analysis of 75 cases

目的进一步了解甲状腺功能亢进性心脏病(甲亢心)临床特点。方法回顾性分析甲亢心患者的临床资料。其中75例,男30例,女45例,年龄17～84岁,病程1月～30年;伴心功能衰竭47例(63%),心房纤颤47例(63%),病窦综合征2例(3%);左房扩大48例(66%),左室扩大3l例(43%),右房扩大30例(41%),右室扩大35例(47%),全心扩大18例(25%),二尖瓣返流48例,三尖瓣返流45例,主动脉瓣返流34例,伴肺动脉高压33例(44 mm Hg±7 mm Hg,左室射血分数60%±19%)。结论甲亢心临床表现多种多样,常规治疗效果欠佳的心脏病应常规筛查甲状腺功能以除外甲亢心;治疗的关键是甲亢。

Objective To investigate the clinical features of thyrotoxic heart disease. Methods The clinical data of 75 patients with thyrotoxic heart disease, 30 males and 45 females, aged 54. 3 ± 14.4 （17 -84, with the course from 1 month to 30 years, were analyzed retrospectively. Results Forty-seven of the 75 patients （63%）presented heart failure, 47 patients （63%） showed atrial fibrillation, 2 patients （3%） showed sick sinus syndrome ; 48 patients （66%） showed left atrial enlargement, 31 （43%） showed left ventricular enlargement, 30 （41%） showed right atrial enlargement, 35 （47%） showed right ventricular enlargement, and 18 （25%） showed entire heart enlargement. Mitral valve regurgitation occurred in 45 patients, tricuspid regurgitation in 45, aortic valve regurgitation in 34, and pulmonary artery hypertension （with the pulmonary blood pressure of 44 ± 7 mm Hg and LVEF of 60%± 19% ） in 33 patients. Conclusion The chnical manifestations of thyrotoxic heart disease are various Thyroid function should be investigated to exclude thyrotoxic heart disease when routine treatment is ineffective in heart disease. The key point of treatment is hyperthyroidism.