老年甲状腺功能亢进性心脏病16例临床误诊剖析.docVIP

老年甲状腺功能亢进性心脏病16例临床误诊剖析 　　doi：10.3969/j.issn.1007-614x.2014.21.80 　　摘 要 目的：探讨老年甲状腺功能亢进性心脏病（甲亢心脏病）的临床特点。方法：回顾性分析66例老年甲状腺功能亢进性心脏病患者临床诊断资料。结果：临床表现：21例甲亢症状典型，45例甲亢症状不典型；66例甲亢性心脏病中表现心力衰竭30例。误诊情况：66例甲亢性心脏病患者有16例误诊；16例误诊均因甲亢症状不典型；明确诊断者经抗甲亢治疗，均有效。误诊病例经确诊后经抗甲亢治疗，心力衰竭缓解较慢，心电图表现心房纤颤者，经治疗均未转为窦性心律。结论：甲亢心脏病临床表现形式多样，对原因不明的心律失常、心脏扩大以及心力衰竭患者，应尽早检查其甲状腺功能，以便早期发现和诊断甲亢心，减少误诊、漏诊。 　　关键词 老年 甲状腺功能亢进性心脏病 临床误诊 　　Analysis of clinical misdiagnosis of 66 cases with senile hyperthyroid heart disease 　　Li Zhijie1，Zhang Wenshu2，Zhang Guoping3 　　The First Department of Internal Medicine，the Peoples Hospital of Handan city，Hebei 0650011 　　Nanxin Street Community Health Service Station of Maoxi Street，Han Shan Trade of Handan City，Hebei 0650002 　　General Hospital of Minmetals Hanxing Employees 0560013 　　Abstract Objective：To investigate the clinical characteristics of senile hyperthyroid heart disease.Methods：66 elderly patients with hyperthyroid heart disease were selected.Analyse their clinical diagnosis data retrospectivly.Results：Clinical manifestation：21 cases with typical symptoms，45 cases with atypical symptoms.Among 66 cases with hyperthyroid cardiac disease，30 cases of heart failure.Misdiagnosis：Among 66 cases with hyperthyroid heart disease，16 cases were misdiagnosed.16 cases of misdiagnosis because of hyperthyroidism symptoms not typical.Patients definite diagnosised were treated anti hyperthyroidism therapy，and all effectively.After the misdiagnosis cases were diagnosed and given anti hyperthyroidism therapy，heart failure relieved，and ECG showed that atrial fibrillation，but they were not converted to sinus rhythm after treatment.Conclusion：The clinical manifestation of hyperthyroid heart disease had variously forms，for unexplained cardiac arrhythmia，heart enlargement and heart failure patients，we should check the thyroid function as soon as possible，in order to detection and diagnosis of hyperthyroid heart disease early，to reduce misdiagnosis and missed diagnosis. 　　Key words The