甲状腺机能亢进性心脏病X线表现分析

X-ray manifestation in hyperthyroid cardiac disease

目的 :探讨甲状腺机能亢进性心脏病 (以下简称甲亢性心脏病 )的 X线表现分析与诊断。 方法 :对临床上诊断的 5 1例甲亢性心脏病患者均拍摄胸部正、侧位平片 ,其中 19例同时行胸部透视 ,观察心脏形态的改变、心脏及大血管的搏动情况 ,分析肺循环改变。经过测量心胸比率观察心脏各房室的增大。12例做了心脏 B超检查。结果 :X线表现 :心脏增大占 78.6 % ,多数为轻—中度增大 (74.4% )。心脏各房室增大 ,以右心室增大者为多数 ,其次有左、右心室增大及左室增大。心脏形态以二尖瓣型心脏为多 ,占 80 .4% ,其次表现为主动脉型及二尖瓣 -普大型心脏。肺动脉段突隆 ,心脏及肺动脉搏动增强。结论 :甲亢性心脏病在 X线片上有一定的特征性改变 ,但确定诊断必须紧密结合临床及其他检查资料 ,并与先天性房间隔缺损、肺心病、风湿性心脏病进行鉴别。

Objective: To probe X ray manifestation as well as diagnosis of hyperthyroid cardiac disease. Methods: Clinical dignosis of 51 patients with hyperthyroid cardiac disease were taken post anterior and lateral chest films; and 19 patients taken fluoroscopy, measured cardiac thorax ratio; observed enlargement of atriums and ventricles; analysed the changes of pulmonary circulation; observed state of great vessels and cardiac pulsation. 12 patients were taken cardiac ultrasonics. Results: On the x ray, mild and moderate cardiac enlargement by 78.6% of patients with byperthyroid cardiac disease, mitral type of cardiac enlargement on silhouettes could be seen firstly, 80.4%; aortic type and mitralization generalized enlargement type could be seen secondly. Pulmonary congestion,prominence of pulmonary artery segment, enforcement of rhythmical of heart could be seen. The right atriums and ventricles of cardiac enlargement were most commonly seen, left ventricles were seen secondly. Conclusion: X ray examination could prove certain features in hyperthyroid cardiac disease, however, the dignosis must closely associated with clinical data.