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一项评估甲状腺功能减退患者心血管变化的前瞻性观察性研究。

A Prospective Observational Study to Evaluate Cardiovascular Changes in Patients of Hypothyroidism.

作者信息

Sawarthia Priyanka, Bhosle Deepak, Kalra Ravi

机构信息

Internal Medicine, Bharati Vidyapeeth Deemed to be University, Pune, IND.

Internal Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, IND.

出版信息

Cureus. 2023 Jun 9;15(6):e40201. doi: 10.7759/cureus.40201. eCollection 2023 Jun.

Abstract

Introduction Hypothyroidism is a common endocrine disorder in India and is easy to diagnose based on clinical manifestations and signs. Thyroid hormone affects the cardiovascular system. Fatiguability, dyspnea, weight gain, lower limb swelling, and bradycardia are some clinical manifestations. ECG changes in hypothyroidism include sinus bradycardia, prolonged QTc interval, changes in the morphology of the T-wave, QRS duration, and low voltage. Echocardiography changes include diastolic dysfunction, asymmetrical septal hypertrophy, and pericardial effusion. This study aimed to examine the cardiovascular changes in patients with hypothyroidism. Methodology Patients with hypothyroidism and cardiovascular changes were assessed using an electrocardiogram and echocardiography. Results A total of 68 hypothyroid patients were enrolled in the study. The mean age of patients was 41.93 ± 15.36 years, and the mean BMI was 24.64 ± 4.30 kg/m. Of 68 hypothyroid patients, 57 (83.8%) were females, and 11 (16.2%) were males. The mean thyroid-stimulating hormone (TSH) level in the study population was 11.48 ± 22.02 (mIU/mL). The most common symptoms reported among the study participants were tiredness or weakness (67.6%), followed by dyspnea (42.6%). The mean pulse rate, systolic blood pressure, and diastolic blood pressure were 81.50 ± 16.16, 112.76 ± 7.05, and 70.68 ± 7.46, respectively. Pallor was the most common sign (22.1%) among all the people who participated in the study. The most common findings on the ECG were low voltage complexes (25%) followed by inversion of the T wave (23.5%). Other ECG findings were bradycardia (10.3%), right bundle branch block (7.4%), and QRS prolongation (2.9%). Echocardiography revealed 21 (30.8%) patients with grade 1 left ventricular diastolic dysfunction and pericardial effusion in two patients (2.94%). There was a significantly greater increase in the level of TSH in study participants. Conclusion Patients with abnormal ECG and echocardiography without other cardiovascular changes should be evaluated for hypothyroidism to improve the quality of care.

摘要

引言

甲状腺功能减退症在印度是一种常见的内分泌疾病,根据临床表现和体征很容易诊断。甲状腺激素会影响心血管系统。疲劳、呼吸困难、体重增加、下肢肿胀和心动过缓是一些临床表现。甲状腺功能减退症的心电图变化包括窦性心动过缓、QTc间期延长、T波形态改变、QRS波时限和低电压。超声心动图变化包括舒张功能障碍、不对称性室间隔肥厚和心包积液。本研究旨在检查甲状腺功能减退症患者的心血管变化。

方法

对患有甲状腺功能减退症且有心血管变化的患者进行心电图和超声心动图评估。

结果

共有68例甲状腺功能减退症患者纳入本研究。患者的平均年龄为41.93±15.36岁,平均体重指数为24.64±4.30kg/m²。68例甲状腺功能减退症患者中,57例(83.8%)为女性,11例(16.2%)为男性。研究人群中促甲状腺激素(TSH)的平均水平为11.48±22.02(mIU/mL)。研究参与者中报告的最常见症状是疲劳或虚弱(67.6%),其次是呼吸困难(42.6%)。平均脉搏率、收缩压和舒张压分别为81.50±16.16、112.76±7.05和70.68±7.46。面色苍白是所有参与研究的人中最常见的体征(22.1%)。心电图最常见的表现是低电压复合波(25%),其次是T波倒置(23.5%)。其他心电图表现为心动过缓(10.3%)、右束支传导阻滞(7.4%)和QRS波延长(2.9%)。超声心动图显示21例(30.8%)患者有1级左心室舒张功能障碍,2例(2.94%)患者有心包积液。研究参与者中TSH水平有显著更高的升高。

结论

对于心电图和超声心动图异常但无其他心血管变化的患者,应评估其是否患有甲状腺功能减退症,以提高护理质量。

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Hypothyroidism.甲状腺功能减退症。
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Thyroid hormones and cardiovascular disease.甲状腺激素与心血管疾病。
Nat Rev Cardiol. 2017 Jan;14(1):39-55. doi: 10.1038/nrcardio.2016.174. Epub 2016 Nov 4.
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Subclinical thyroid disease.亚临床甲状腺疾病。
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