Niakara A, Nébié L V, Drabo Y J
Service de cardiologie, Centre hospitalier national Yalgado Ouédraogo (CHNYO), Ouagadougou, Burkina Faso.
Bull Soc Pathol Exot. 2000 Feb;93(1):25-8.
Cardiothyreosis is a relatively frequent condition in Sub-Saharan Africa and represents 1.7% of cardiac admissions in Ouagadougou. In this retrospective study, our aim has been to describe clinical characteristics of the disease and its cross-disciplinary management. Over a period of six years (1993-1998), we observed 32 cases of cardiothyreosis at the Centre Hospitalier Yalgado Ouedraogo. Average age was 43.3 +/- 14.7, with a clear majority of women (78.1%). Systolic blood pressure was on average 136 +/- 5 mmHg and mean diastolic blood pressure was 78 +/- 16 mmHg. Mean heart frequency was measured at 125 +/- 27 beats/minute and we detected 13 cases (41%) of atrial fibrillation. Heart failure occurred in 22 cases (69%). Underlying mitral valvulopathy was found in 5 cases. Arrhythmia was reduced in 53% of the cases, after treating with betablocker or cibenzoline (4 cases). Eighteen out of 25 patients presented anaemia (72%), 64% had hypocalcemia, and 50%--hypokaliemia. The average cardio-thoracic index was 0.63 +/- 0.09 with extremes of 0.75 and 0.40. An echocardiogramme was conducted for 10 patients and showed atrial dilation in 4 cases and ventricular dilation in one case. This turned out to be Basedow illness in 62.5% of the cases and multinodular goitre in 37.5%. Mean hospitalisation was 18.3 +/- 12.7 days. Antithyroidian treatment led to a positive evolution in 97% of the cases (only one death occurred through refractory heart failure).
在撒哈拉以南非洲地区，心肌甲状腺病变是一种较为常见的病症，在瓦加杜古的心脏科住院病例中占1.7%。在这项回顾性研究中，我们旨在描述该疾病的临床特征及其多学科管理情况。在六年时间（1993 - 1998年）里，我们在亚尔加杜奥德拉戈中心医院观察到32例心肌甲状腺病变病例。平均年龄为43.3 ± 14.7岁，其中女性占绝大多数（78.1%）。收缩压平均为136 ± 5 mmHg，平均舒张压为78 ± 16 mmHg。平均心率测得为125 ± 27次/分钟，我们检测到13例（41%）心房颤动病例。22例（69%）出现心力衰竭。发现5例存在潜在的二尖瓣病变。在用β受体阻滞剂或西苯唑啉治疗后（4例），53%的病例心律失常得到缓解。25例患者中有18例（72%）出现贫血，64%有低钙血症，50%有低钾血症。平均心胸指数为0.63 ± 0.09，范围在0.75至0.40之间。对10例患者进行了超声心动图检查，其中4例显示心房扩大，1例显示心室扩大。结果显示，62.5%的病例为巴塞多病，37.5%为结节性甲状腺肿。平均住院时间为18.3 ± 12.7天。抗甲状腺治疗使97%的病例病情好转（仅1例因难治性心力衰竭死亡）。
