中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
25期
24-25
,共2页
治疗%心脏病%诊断%甲状腺机能减退
治療%心髒病%診斷%甲狀腺機能減退
치료%심장병%진단%갑상선궤능감퇴
Treatment%Heart disease%Diagnosis%Hypothyroidism
目的：探讨甲状腺机能减退性心脏病患者的诊断及治疗方法。方法甲状腺机能减退性心脏病患者48例,对患者采用甲状腺片口服的治疗方法,从小剂量(15~30 mg/d)开始逐渐加量,加至90~120 mg/d,并维持治疗,观察治疗效果。结果治疗前射血前期(PEP)、射血期(ET)、射血前期与射血期比值(PEP/ET)、每搏输出量(SV)、心输出量(CO)、射血分数(EF)分别为(114±6)ms、(291±57) ms、(0.39±0.04)分、(72±8)ml、(4.2±0.7)L/min、(68±6)%,治疗后各项指标分别为(96±4) ms、(290±55) ms、(0.32±0.03)分、(86±6)ml、(5.4±0.8)L/min、(53±6)%,治疗前后比较差异具有统计学意义(P<0.05)；心脏彩超检查显示心功能改善,且之前心脏扩大者心脏有回缩趋势,射血分数增加。结论甲状腺机能减退性心脏病的起病症状不明显,进展缓慢,临床表现不典型,易被误诊,因此要与冠心病和心功能不全相鉴别。确诊方法为血清甲状腺功能测定,诊断中可采用超声心动图,对于其治疗,口服甲状腺片是一种安全有效的方法,预后较好。
目的：探討甲狀腺機能減退性心髒病患者的診斷及治療方法。方法甲狀腺機能減退性心髒病患者48例,對患者採用甲狀腺片口服的治療方法,從小劑量(15~30 mg/d)開始逐漸加量,加至90~120 mg/d,併維持治療,觀察治療效果。結果治療前射血前期(PEP)、射血期(ET)、射血前期與射血期比值(PEP/ET)、每搏輸齣量(SV)、心輸齣量(CO)、射血分數(EF)分彆為(114±6)ms、(291±57) ms、(0.39±0.04)分、(72±8)ml、(4.2±0.7)L/min、(68±6)%,治療後各項指標分彆為(96±4) ms、(290±55) ms、(0.32±0.03)分、(86±6)ml、(5.4±0.8)L/min、(53±6)%,治療前後比較差異具有統計學意義(P<0.05)；心髒綵超檢查顯示心功能改善,且之前心髒擴大者心髒有迴縮趨勢,射血分數增加。結論甲狀腺機能減退性心髒病的起病癥狀不明顯,進展緩慢,臨床錶現不典型,易被誤診,因此要與冠心病和心功能不全相鑒彆。確診方法為血清甲狀腺功能測定,診斷中可採用超聲心動圖,對于其治療,口服甲狀腺片是一種安全有效的方法,預後較好。
목적：탐토갑상선궤능감퇴성심장병환자적진단급치료방법。방법갑상선궤능감퇴성심장병환자48례,대환자채용갑상선편구복적치료방법,종소제량(15~30 mg/d)개시축점가량,가지90~120 mg/d,병유지치료,관찰치료효과。결과치료전사혈전기(PEP)、사혈기(ET)、사혈전기여사혈기비치(PEP/ET)、매박수출량(SV)、심수출량(CO)、사혈분수(EF)분별위(114±6)ms、(291±57) ms、(0.39±0.04)분、(72±8)ml、(4.2±0.7)L/min、(68±6)%,치료후각항지표분별위(96±4) ms、(290±55) ms、(0.32±0.03)분、(86±6)ml、(5.4±0.8)L/min、(53±6)%,치료전후비교차이구유통계학의의(P<0.05)；심장채초검사현시심공능개선,차지전심장확대자심장유회축추세,사혈분수증가。결론갑상선궤능감퇴성심장병적기병증상불명현,진전완만,림상표현불전형,역피오진,인차요여관심병화심공능불전상감별。학진방법위혈청갑상선공능측정,진단중가채용초성심동도,대우기치료,구복갑상선편시일충안전유효적방법,예후교호。
Objective To investigate the methods of diagnosis and treatment for hypothyroid heart disease. Methods A total of 48 cases of hypothyroid heart disease were treated by oral administration of thyroid tablets. Beginning with a small dose (15~30 mg/d), the amount was increased to 90~120 mg/d and maintained in the treatment. Results The indexes of pre-ejection period (PEP), ejection time (ET), ratio of pre-ejection period and ejection time (PEP/ET), stroke volume (SV), cardiac output (CO), ejection fraction (EF) were (114±6)ms, (291±57)ms, (0.39±0.04), (72±8)ml, (4.2±0.7)L/min, and (68±6)%before the treatment. The indexes after the treatment were (96±4)ms, (290±55)ms, (0.32±0.03), (86±6)ml, (5.4±0.8)L/min, and (53±6)%. Their difference had statistical significance (P<0.05). The result of ultrasonic cardiogram showed improvement of heart function, increased ejection fraction, and retraction trend of cardiac dilatation. Conclusion The onset symptoms of hypothyroid heart disease are not apparent, and its progress is slow. The clinical manifestation is not typical and can be easily misdiagnosed. Therefore it should be distinguished from coronary heart disease and cardiac insufficiency. The diagnosis method is the determination of serum thyroid function. Ultrasonic Heartbeat diagnosis can be used. For the treatment method, oral administration of thyroid tablets is a safe and effective method and the prognosis is good.
