甲状腺毒症性心脏病核素治疗的心电图和甲状腺功能水平分析

Analysis on the electrocardiogram and the level of thyroid function after the radionuclide therapy for thyrotoxic heart disease

目的探讨甲状腺毒症性心脏病131I治疗前后的心电指标和甲状腺功能水平的变化。方法对176甲状腺毒症性心脏病患者行12导联同步心电图检查和血清甲状腺激素FT3、FT4、TSH水平检测,分析对比在131I治疗前后的变化。结果治疗前心电图检查有不同程度的ST-T病理性下降和T波改变(降低、双向、倒置),在Ⅱ、Ⅲ导联可出现"不典型的肺型P波"或低振幅的双峰变型P波,P-Q间期及Q-T间期延长,FT3、FT4升高,TSH降低。治疗后相关指标多恢复正常,差异有统计学意义(P<0.05)。结论心电图检测和甲状腺激素水平测定是指导甲状腺毒症性心脏病131I治疗的重要手段。

Objective To observe the changes of the index of electrocardiogram and the level of thyroid function after the t3I radionuclide therapy for thyrotoxie heart disease. Methods 176 cases of thyrotoxie heart disease were selected for researching, the examination of 12 lead synchronous ECG and the levels of FT3,FT4 and TSH were analyzed and compared before and after the treatment of 13q radionuclide therapy. Results Before the treatment,the ECG showed that different degrees of ST-T＇s pathological decline and T wave changes （decline,two-way and inversion）,the I/ and III lead showed that the untypical pulmonary P wave or low amplitude bimodal variant P wave,the P-Q and Q-T interval prolongation,the levels of FT3,FT4 increased and the level of TSH decreased.After the treatment,the relative indexes were almost recovered to normal level,and had statistical differences （P〈0.05）. Conclusion The examination of ECG and the level of thyroid hormone is the very important method for the guiding 131I radionuclide therapy for thyrotoxic heart disease.