Graves病伴发甲状腺毒症性心脏病128例临床分析

Clinical analysis of 128 cases of primary hyperthy roidism complicating hyperthyroid heart disease

目的分析甲状腺毒症性心脏病的发病率、临床特征、危险因素和131I治疗效果。方法回顾性分析2009年4～6月连续收治的1443例GD患者(甲状腺毒症性心脏病组128例,单纯Graves病组1315例)的临床资料,包括一般资料、临床表现、治疗预后、心电图和超声心动图变化。结果甲状腺毒症性心脏病的整体发病率约8.9%,131I治疗后总有效率96.9%。Logistic回归分析发现FT4越高、男性患者、年龄越大和病程越长者出现甲状腺毒症性心脏病的危险越大,其OR值分别为3.15、2.17、1.71和1.57。结论131I治疗甲亢性心脏病安全、有效,可作为首选治疗方法;高FT4水平、男性、年龄大和病程较长是Graves病患者出现甲亢性心脏病的独立危险因素,应给予必要的预防与治疗。

Objective To explore the prevalence , clinical feature and risk factors of hyperthyroid heart disease and ena- ble correct treatment. Methods Clinical datas of 1443 cases of Craves disease including 128 cases of hyperthyroid heart disease were investigated retrospectively from April to June in 2009. Results The prevalence of hyperthyroid heart disease was 8.9% , and the total effective rate after radioiodine-131 therapy were 96.9%. Logistic regression analysis showed that the FT4, male, age and progress are the independent risk factors of hyperthyroid heart disease, their OR values are 3.15 -2. 17,1.71 and 1.57 respectively. Conclusion Hyperthyroid heart disease is common in GD patients, it should be paid attention to those patients with higher FT4, male,elder and longer course of disease. Radioiodine-131 therapy should be the first choice for those patients.