甲状腺功能亢进性心脏病57例临床分析

HYPERTHYROID HEART DISEASE: CLINICAL ANALYSIS OF 57 PATIENTS

目的探讨甲状腺功能亢进（简称甲亢）性心脏病病人的临床特点。方法搜集2009年10月—2010年5月本院内分泌科收治的57例甲亢性心脏病和80例甲亢病人的临床资料,并进行统计学分析。结果甲亢性心脏病并发心功能不全者14例（24.6%）,其中右心功能不全11例（19.3%）;心功能Ⅲ级5例,均为右心功能不全。甲亢性心脏病并发心律失常以心房颤动最为常见,共44例（77.2%）。甲亢性心脏病病人的甲亢病因类型以弥漫性毒性甲状腺肿居多,共41例（71.9%）;其次为桥本病11例（19.3%）。甲亢性心脏病组与甲亢组比较,前者年龄较大、病程较长、FT4水平较高、促甲状腺激素（TSH）水平较低,差异有显著性（F=4.872~19.852,P〈0.05）。结论年龄较大、病程较长、FT4水平较高、TSH水平较低、弥漫性毒性甲状腺肿的甲亢病人更易发生甲亢性心脏病,甲亢性心脏病易发生右心功能不全、心房颤动。

Objective To investigate the clinical characteristics of patients with hyperthyroid heart disease（HHD）.Methods Clinical data of 57 HHD patients and 80 with hyperthyroidism（HT）,hospitalized from October 2009 to May 2010 in our hospital,were collected and analyzed statistically. Results Of 57 HHD patients,14（24.6%） were complicated with cardiac insufficiency,mainly（11 cases） being right heart insufficiency;five with graded Ⅲ heart function were right heart dysfunction.Atrial fibrillation was the most common arrhythmia in HHD,44（77.2%） were noted in this group.Diffuse toxic goiter was the main cause of HHD,accounting for 41 cases（71.9%）,followed by Hashimoto＇s disease,11 cases（19.3%）.In comparison between groups of HHD and HT,those in HHD were older,longer cause of disease,higher level of FT_4 and lower level of TSH in plasma,the differences being significant between the two groups（F=4.872-19.852,P0.05）. Conclusion The patients who suffer from hyperthyroidism in older age,with longer course of disease,higher FT_4,lower TSH and diffuse toxic goiter,are more likely to develop hyperthyroid heart disease,right heart insufficiency and atrial fibrillation are common in this condition.