甲状腺功能减退症合并心包积液的临床分析

Study the clinical analysis of hypothyroidism with pericardial effusion

目的 对甲状腺功能减退症 (甲减 )合并心包积液进行临床分析加以探讨 ,以使治疗工作中减少误诊、漏诊 ,提高治愈率。方法 诊断明确基础上用甲状腺素片治疗 ,初始用小剂量 ,每日 15～ 30 mg,逐增每日 40～12 0 m g,维持量 40～ 80 m g。结果 4～ 8周治疗 ,甲状症状明显改善 ,ECG恢复正常 ,X线及心动超声亦恢复正常 ,T3、T4、TSH恢复正常或明显好转。结论 遇到原因不明心包积液而心包填塞症状不明显 ,同时伴有或不伴有心动过缓均应想到甲减的可能 ,甲减性心包积液不应行常规心包穿刺抽液 ,应早期强心利尿 ,使用甲状腺素片治疗 ,心包积液即可消失。

Objective To study the clinical analysis of hypothyroidism with pericardial effusion in order to decrease misdiagnoses in our work and raise the cure rate.Methods Thyroxine was used on the basis of clear and definite diagnoses.At first one small dose about 15~30 mg a day gradually.The maintenance dose was 40~80 mg.Results After 4~8 weeks,the symptom of hypothyrodism obviously get better.ECG,X ray and echocardiogram returened to normal.The same with T 3,T 4,TSH,or at least T 3,T 4,TSH took a turn for better.Conclusions We think that whether or not bradycardia auompanies,hypothyroidism is possible if the causes of pericardial effusion are unclear and cardial tamponade is not obvious.Pericardial effuscon are unclear and cardial tamponade is not obvious.Pericardiopuncture can't be applied to hypothyroid cardiopathy as conventional pactlie.Instead by cardiol diuresis and using thyroxine,pericardial effusion will disappear.