摘要
目的探讨甲状腺功能亢进(Graves病)患者^(131)I治疗后心脏结构及功能逆转情况。方法选择成都医学院第二附属医院·核工业四一六医院372例经^(131)I治疗的甲亢(Graves病)患者为试验组、168例未经治疗的甲亢患者为甲亢组,149例健康成人为正常组作为研究对象,收集患者的一般资料及超声心动图数据,将3组病例超声心动图数据依据年龄分组和不分年龄组分别进行统计学分析。结果1)甲亢组:与正常组相比(不分年龄组),左房、右房及左室长大病例数及心动过速、心动过缓、心律不齐、肺动脉高压的发生率差异有统计学意义(P<0.05),左房、右房、肺动脉内径及AV差异有统计学意义(P<0.01);与正常组相比(按年龄分组),≥50岁病例组左房、右房长大病例数及肺高压及心律不齐病例数差异有统计学意义(P<0.05),≤39岁年龄组心动过速病例右房及肺动脉内径差异有统计学意义(P<0.05),≥50岁年龄组左房及右房内径差异有统计学意义(P<0.01),各年龄组AV值差异均有统计学意义(P<0.01);2)试验组:与甲亢组相比(不分年龄组),左房、右房及左室长大病例数及心动过速、心动过缓、心律不齐、肺动脉高压的发生率差异有统计学意义(P<0.05),左房、右房内径及AV值差异有统计学意义(P<0.01);与甲亢组相比(按年龄分组),≥50岁年龄组左房及右房长大病例数及肺高压发生率差异有统计学意义(P<0.05),≤49岁年龄组心动过速的发生率差异有统计学意义(P<0.05),≥40岁年龄组心律不齐的发生率差异有统计学意义(P<0.05),≤39岁年龄组右房测值差异有统计学意义(P<0.01),≥50岁年龄组左、右房内径及EF值差异有统计学意义(P<0.01),AV测值各年龄组差异均有统计学意义(P<0.05);与正常组相比,无论是否按年龄分组心脏结构改变病例数及心动过缓、心动过速、肺高压及心律不齐的发生率差异无统计学意义(P>0.05),不分年龄组AV差异有统计学意义(P<0.05)。结论^(131)I治疗甲亢后患者房室结构改变能够得到很大程度的逆转,心动过速、心律不齐以及肺动脉高压的发生率也能得到有效降低,左室收缩功能及主动脉瓣前向血流速度能够得到很大程度的恢复,心动过缓的发生率与正常人比较无明显差异。
Objective To investigate the reversion of cardiac structure and function in patients with hyperthyroidism(Graves disease)after^(131)I treatment.Methods Subjects of study were selected from the Second Affiliated Hospital of Chengdu Medical College(416 Hospital of Nuclear Industry),among which 372 patients with hyperthyroidism(Graves disease)treated with^(131)I were selected as the treatment group,168 patients with untreated hyperthyroidism as the hyperthyroidism group,and 149 healthy adults as the normal group.General information and echocardiographic data of the patients were collected.And the echocardiographic data of the 3 groups were statistically analyzed according to age and regardless of age.Results 1.Hyperthyroidism group:Compared with the normal group(regardless of age),there were significant differences in the number of cases of left atrial,right atrial and left ventricular enlargement,in the incidence of tachycardia,bradycardia,arrhythmia and pulmonary hypertension(P<0.05),and in left atrial,right atrial,pulmonary artery diameter and aorta valve(AV)value(P<0.01).And compared with the normal group(grouped by age),there were significant differences in the number of cases of left atrial enlargement,right atrial enlargement,pulmonary hypertension and arrhythmia between the two groups of patients≥50 years old(P<0.05),there were significant differences in the cases of tachycardia,in the diameter of right atrial and pulmonary artery between the two groups of patients≤39 years old(P<0.05),there were significant differences in the diameter of left atrial and right atrial between the two groups of patients≥50 years old(P<0.01),there were significant differences in AV values between groups of the same age(P<0.01).2.Treatment group:Compared with the hyperthyroidism group(regardless of age),there were significant differences in the number of cases of left atrial,right atrial and left ventricular enlargement,in the incidence of tachycardia,bradycardia,arrhythmia and pulmonary hypertension(P<0.05),and in left atrial,right atrial diameter and AV values(P<0.01).Compared with the hyperthyroidism group(grouped by age),there were significant differences in the number of cases of left atrial enlargement and right atrial enlargement,and in the incidence of pulmonary hypertension between the two groups of patients≥50 years old(P<0.05),there was significant difference in the incidence of tachycardia between the two groups of patients≤49 years old(P<0.05),there was significant difference in the incidence of arrhythmia between the two groups of patients≥40 years old(P<0.05),there was significant difference in the right atrial measurement between the two groups of patients≤39 years old(P<0.01),there were significant differences in the diameter of left and right atrial and ejection fraction(EF)between the two groups of patients≥50 years old(P<0.01),there were significant differences in AV values between groups of the same age(P<0.05).Compared with the normal group,grouped by age or not,there was no statistical significance in the number of cases of cardiac structural changes,and in the incidence of bradycardia,tachycardia,pulmonary hypertension and arrhythmia(P>0.05).There was significant difference in AV value when not grouped by age(P<0.05).Conclusion After^(131)I treatment,atrioventricular structural changes in patients with hyperthyroidism can be reversed to a great extent,the incidence of tachycardia,arrhythmia and pulmonary hypertension can also be effectively reduced,the left ventricular systolic function and aortic valve forward blood flow velocity can be greatly restored,and the incidence of bradycardia was not significantly different from that of normal subjects.
作者
曾卓华
刘家开
邓楠
吴垠
徐可
Zeng Zhuohua;Liu Jiakai;Deng Nan;Wu Yin;Xu Ke(The Second Affiliated Hospital of Chengdu Medical College·416 Hospital of Nuclear Industry,Chengdu 610051,China)
出处
《成都医学院学报》
CAS
2021年第3期345-350,共6页
Journal of Chengdu Medical College
