甲状腺功能亢进性心脏病治疗前后的心电图变化

Changes of electrocardiogram before and after treatment of hyperthyroid heart disease

目的探讨甲状腺功能亢进性心脏病治疗前后的心电图变化。方法回顾性研究7例甲状腺功能亢进性心脏病患者入院治疗前后的心电图变化。结果经服抗甲状腺药物治疗后,甲状腺功能亢进病情缓解,心力衰竭好转,但左室肥大无好转,5例快速心房颤动中2例转为窦性心律,2例心室率降至<100次/min;房性或室性早搏4例经治疗后3例消失,1例无明显改善。治疗后室上性心动过速1例,快-慢综合征1例,右束支传导阻滞1例,Ⅰ度房室传导阻滞1例,Ⅱ度房室传导阻滞1例。结论临床上如发现患者有心律失常,尤其是快速心房颤动而未找到其病因时,应行有关甲状腺功能检查,以明确有无甲状腺功能亢进性心脏病。

Objective To discuss the changes of electrocardiogram before and after treatment of hyperthyroid heart disease. Methods The changes of electrocardiogram before and after treatment of 7 hyperthyroid heart disease patients were retrospectively analyzed. Results After treatment with antithyroid drugs, hyperthyroidism relieved and heart failure improved, but left ventricular hypertrophy did not improve. In 5 cases of rapid atrial fibrillation, 2 cases turned to sinus rhythm, and 2 cases had ventrieular rate dropped to 〈100 times/min. In 4 cases of atrial or ventricular premature beat, 3 cases disappeared and no obvious improvement was found in 1 case. After treatment, supraventricular tachycardia was seen in 1 case, fast slow syndrome in 1 case, fight bundle branch block in 1 cases, grade I atrioventricular block in 1 case, and second degree atrioventricular block in 1 case. Conclusion If there is arrhythmia in clinic, especially in cases of rapid atrial fibrillation without finding its causes, the thyroid function should be checked to clarify whether there is hyperthyroidism heart disease.