原发性甲状旁腺功能亢进症84例心电图特征分析

Analysis of Electrocardiographic Characteristics in 84 Patients With Primary Hyperparathyroidism

目的：分析原发性甲状旁腺功能亢进症（PHPT）患者的心电图表现,并与正常人心电图作对比,同时探讨心电图异常与血钙水平的关系。方法：收集我院2010-01至2014-04期间收治的84例PHPT患者为观察组,另选择同期健康体检的成人80例作为对照组,比较两组受检者的心电图异常情况;同时根据血钙（Ca2＋）三分位水平将观察组患者分为3个亚组,即血Ca2＋：2.0~2.8 mmol/L者28例、2.8~3.1 mmol/L者28例和〉3.1 mmol/L者28例,比较3个亚组间心电图异常情况。探讨心电图异常与血钙水平关系。结果：观察组心电图异常率为83.3%,对照组异常率为18.8%,两组比较差异有统计学意义（P〈0.001）。观察组患者心电图异常情况中,以ST-T段改变、QRS波增宽、左心室高电压及QT间期缩短为主。与对照组相比,观察组上述心电图异常指标差异均有统计学意义（P〈0.001或P〈0.05）。观察组患者随着血钙水平的增高,ST-T段改变、左心室高电压的发生率逐渐增加,且ST-T段改变在3个亚组间比较,差异有统计学意义（P〈0.05）。而QT间期随着血钙水平增高逐渐缩短,QRS波宽随着血钙水平升高而增宽,3个亚组间比较,差异有统计学意义（P均〈0.05）。结论：PHPT患者的心电图异常率较高,与血钙水平呈正相关。

Objective：To analyze the electrocardiographic （ECG） characteristics in patients with primary hyperparathyroidism（PHPT） and meanwhile,to explore the relationship between ECG abnormality and serum calcium level in relevant patients.Methods：Our study included 2 groups：Observation group,n =84 PHPT patients treated in our hospital from 2010-01 to 2014-04 and Control group,n =80 normal subjects from regular physical examination at the same period.The ECG manifestation was compared between 2 groups.Meanwhile,according to tertile levels of serum calcium,PHPT patients were further divided into 3 subgroups：1 Ca2＋ level（2.0-2.8） mmol/L,2 Ca2＋ level（2.8-3.1） mmol/L,3 Ca2＋ level 〉3.1 mmol/L and n =28 in each subgroup.The ECG abnormalities were compared among 3 subgroups and the relationship between ECG changes and serum calcium levels were studied.Results：The ECG abnormality rates in Observation group and Control group were as 83.3% vs 18.8%,P 〈0.001.Compared with Control group,Observation group presented more frequent ST-T changes,QRS duration widening,high left ventricular pressure and QT interval shortening,P 〈0.001 or P 〈0.05.In observation group,with the rising of serum calcium,the incidences of ST-T changes and high left ventricular pressure were increased accordingly,the ST-T changes among 3 subgroups were significant,P 〈0.05;while with the rising of serum calcium,the QT interval was shortened and QRS duration was widened accordingly,the differences were obvious among 3 subgroups,all P 〈0.05.Conclusion：PHPT patients have the higher incidence with abnormal ECG,while ECG abnormality has been related to serum calcium level in relevant patients.