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目的分析老年甲状腺功能亢进性心脏病(HHD)的临床特点及不同心功能级别临床特点的差异。方法收集2000年4月-2009年4月住院老年HHD(80例)与无HHD的老年甲亢患者(180例)临床资料,分析HHD不同心功能级别的临床情况差异。结果 HHD老年组病程(70.52±10.04)个月,合并骨质疏松13例,肝功能损伤11例;无HHD老年甲亢组病程(32.59±7.83)个月,合并骨质疏松7例,肝功能损伤8例,两组比较有统计学意义(P<0.05)。老年HHD组伴发心房颤动51例。心功能Ⅳ级甲状腺不大者6例,心功能Ⅰ级甲状腺不大者1例;心功能Ⅲ级甲状腺Ⅲ度肿大者3例,心功能Ⅰ级甲状腺Ⅲ度肿大者0例;心功能Ⅱ级平均住院时间(14.43±6.99)天,心功能Ⅰ级平均住院时间(9.56±3.00)天,比较有统计学意义(P<0.05)。结论毒性弥漫性甲状腺肿是住院老年HHD最常见病因。老年HHD好发于病程长的患者,心律失常主要表现为心房颤动,病程越长心功能越差,心力衰竭程度与甲功及甲状腺肿大的程度不成比例。
Objective To analyze the clinical features of elderly hyperthyroidism (HHD) and the clinical features of different cardiac function. Methods The clinical data of elderly HHD patients (180 cases) and elderly hyperthyroid patients (180 cases) without HHD from April 2000 to April 2009 were collected to analyze the clinical differences of HHD with different cardiac function levels. Results The duration of HHD elderly group was (70.52 ± 10.04) months, with 13 cases of osteoporosis and 11 cases of hepatic injury. The duration of HHD-free elderly hyperthyroidism group was 32.59 ± 7.83 months, with osteoporosis in 7 cases and liver injury 8 cases, the two groups were statistically significant (P <0.05). Aged patients with HHD group associated with atrial fibrillation in 51 cases. 6 cases of cardiac function grade IV thyroid gland, 1 case of cardiac function grade I hypothyroidism, 3 cases of grade III thyroid gland enlargement, 0 case of grade III thyroid gland enlargement, 0 case heart function The average length of hospital stay was (14.43 ± 6.99) days for grade Ⅱ and 9.56 ± 3.00 for grade Ⅰ for cardiac function (P <0.05). Conclusion Toxic diffuse goiter is the most common cause of hospitalized elderly HHD. Elderly HHD occurs in patients with long duration, arrhythmia mainly for atrial fibrillation, the longer the course of heart function worse, the degree of heart failure and thyroid function and goiter is disproportionate.