以胸腔积液为首发症状的甲亢性心脏病7例

Pleural effusion as the first symptom in 7 patients with hyperthyroid heart disease

目的探讨甲状腺功能亢进性心脏病合并胸腔积液的特点和误诊原因。方法分析7例甲状腺功能亢进性心脏病合并胸腔积液误诊的临床资料。结果入院前误诊为癌性胸腔积液2例,结核性胸腔积液3例,肺炎旁胸腔积液2例。确诊后给予抗甲亢、利尿等治疗,效果明显。结论对胸腔积液的患者应详细询问病史,认真查体,积极完善相关检查,当胸腔积液原因不确定,经验治疗效果差时,应想到是否存在甲状腺功能亢进性心脏病可能。

Objective To discuss the characteristics of hyperthyroidism heart disease complicated with pleural effusion and the causes of its misdiagnosis. Methods The clinical data of 7 patients with hyperthyroid heart disease complicated with pleural effusion misdiagnosed were retrospectively analyzed. Results Prior to hospitalization, 2 patients were misdiagnosed as malignant pleural effusion, 3 eases as tuberculous pleura/effusion, and 2 cases as para - pneumonie pleura/effusion. All patients were given inhibitory hyperthyroidism and diuretic treatment and received better effect when they were diagnosed as hyperthyroid heart disease complicated with pleural effusion. Conclusion The patients with pleural effusion should be carefully examined and their medical history should be inquired in details. When the causes of pleural effusion are uncertain and its treatment effect is unfavorable, the possibility of hyperthyroid heart disease should be considered.