Nieswandt J, Wagner S, Schlegel J, Mohr-Kahaly S, Kahaly G
Klinik und Poliklinik für Innere Medizin, Schwerpunkt Endokrinologie und Stoffwechselerkrankungen, Johannes-Gutenberg-Universität Mainz.
Med Klin (Munich). 1999 Jan 15;94(1):9-14. doi: 10.1007/BF03044690.
Hyperthyroid patients often suffer from impaired exercise capacity with dyspnoea. Two well established, non-invasive methods were used to evaluate the influence of hyperthyroidism on cardiopulmonary function.
In 42 patients with hyperthyroidism we performed spirometry and cardiopulmonary exercise testing before and after 7 days of propranolol therapy as well as in euthyroidism.
In hyperthyroidism reduced vital capacity and 1-second capacity were observed (95.5 +/- 2.4% vs 102.6 +/- 1.5%; p = 0.0087; 89.4 +/- 2.3% vs 95.2 +/- 2.2%; p = 0.0179). No changes showed during beta-blockade. At the anaerobic threshold reduced tidal volume and enhanced respiratory frequency were noted (1119.8 +/- 48.9 ml vs 1289.3 +/- 62.7 ml; p = 0.0227; 28.3 +/- 0.8 vs 25.4 +/- 0.9; p = 0.0012). A significant tachycardia could be shown. Impaired response to exercise in pulse and respiratory frequency were observed. Work at the anaerobic threshold was impaired in hyperthyroidism (70 +/- 5 watts vs 86.9 +/- 5.7 watts; p = 0.016) and did not change during propranolol therapy. Oxygen pulse at the anaeorbic threshold was reduced in hyperthyroidism (7.7 +/- 0.4 ml O2/beat vs 9.1 +/- 0.4 ml O2/beat; p = 0.0012) and increased with propranolol (8.9 +/- 0.4 ml O2/beat; p = 0.0001).
In hyperthyroidism significant changes in cardiopulmonary function were noted at rest and exercise. High resting function and impaired response to exercise suggest a cardiopulmonary work with low efficiency. Propranolol leads to economization and lowers patients complaints.
甲状腺功能亢进患者常伴有运动能力受损及呼吸困难。采用两种成熟的非侵入性方法评估甲状腺功能亢进对心肺功能的影响。
对42例甲状腺功能亢进患者,在普萘洛尔治疗7天前后及甲状腺功能正常时进行肺活量测定和心肺运动试验。
甲状腺功能亢进时,肺活量和一秒用力呼气容积降低(分别为95.5±2.4% 对102.6±1.5%;p = 0.0087;89.4±2.3% 对95.2±2.2%;p = 0.0179)。β受体阻滞剂治疗期间无变化。在无氧阈时,潮气量降低,呼吸频率增加(分别为1119.8±48.9 ml对1289.3±62.7 ml;p = 0.0227;28.3±0.8对25.4±0.9;p = 0.0012)。可显示出明显的心动过速。观察到运动时脉搏和呼吸频率的反应受损。甲状腺功能亢进时无氧阈时的做功受损(70±5瓦对86.9±5.7瓦;p = 0.016),普萘洛尔治疗期间无变化。甲状腺功能亢进时无氧阈时的氧脉搏降低(7.7±0.4 ml O₂/次对9.1±0.4 ml O₂/次;p = 0.0012),普萘洛尔治疗后升高(8.9±0.4 ml O₂/次;p = 0.0001)。
甲状腺功能亢进时,静息和运动时心肺功能有显著变化。静息功能高及运动反应受损提示心肺工作效率低。普萘洛尔可提高效率并减轻患者症状。