摘要
目的:探讨甲减心的临床特征并对其误诊原因进行分析,以提高诊断率,降低病死率。方法:回顾分析19例甲减心误诊患者的临床材料。结果:本组19例误诊为冠心病6例,误诊为心包积液、心衰3例。误诊为慢性肾病6例,扩张性心肌病2例,贫血性心脏病2例。误诊时间在2个月～3.5年。明确甲状腺功能减退性诊断后即给予甲状腺片或L(左旋)-甲状腺素治疗。治疗(1～3)个月病情明显改善,经(3～6)个月甲状腺制剂达稳定维持量。TSH控制在(4.0～7.0)mU/L,FT4基本恢复正常。随访(1～4)年,病情控制良好,症状和体征消除,心电图心律失常消失,B超检查心包积液吸收。结论:甲减心起病隐匿,进展缓慢,易于误诊,临床医生应提高对本病的认识,及时检查甲状腺功能等有助于明确诊断,减少误诊。
Objective：Explore clinical features of the hypothyroid heart disease and its analysis of the causes of misdiagnosis in order to improve the diagnostic rate and reduce mortality.Methods：Retrospective analysis of 19 cases of thyroid in patients with hypothyroid ＇heart disease misdiagnosed clinical material.Results：The group of 19 cases misdiagnosed as coronary heart disease in 6 cases,misdiagnosed as perieardial effusion, heart failure,3 cases misdiagnosed as chronic kidney disease in 6 cases,2 cases of dilated cardiomyopathy, isehemic heart disease in 2 cases. Misdiagnosis time in 2 months-3.5 yrs.A clear diagnosis after hypothyroidism given thyroid tablets or L（L）-thyroxine treatment. 1 to 3 months treatment condition improved significantly after 3 to 6 months up to a stable maintenance dose of thyroid preparations.TSH control （4.0-7.0）mU / L, FT4 basically back to normal. Follow-up （1-4）yrs,disease under good control and elimination of symptoms and signs,ECG arrhythmia disappears,Bultrasound absorption of pericardial effusion.Conclusion：Thehypothyroidism heart disease has been slow, easy to misdiagnosis,the clinician should raise awareness of this disease,such as thyroid function be checked in time contribute to a clear diagnosis,reduce misdiagnosis.
出处
《中国医药导刊》
2010年第10期1678-1679,共2页
Chinese Journal of Medicinal Guide
关键词
甲状腺功能减退
心脏病
误诊
Hypothyroidism
Heart disease
Misdiagnosis
