Sharma A K, Mishra S K, Mithal A
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
J Assoc Physicians India. 1995 May;43(5):334-5.
Hyperthyroidism is well known to be associated with cardiovascular manifestations. The authors have noted that patients of well controlled Graves' Disease often pose problems due to intrapoperative cardiovascular instability. Retrospective analysis of 137 case records of patients with Graves' disease (n = 35), toxic nodular goitre (n = 42) and those with euthyroid benign goitre (n = 60) were studied. In Graves' disease cardiovascular instability was found in the form of hypertension (n = 9) associated with tachyarrhythmia (n = 8) and bradycardia (n = 3). The incidence of first 2 of the above mentioned 3 problems was significantly higher in Graves disease (n = 9/35 patients) in contrast to a comparable group of patients with toxic nodular in (3/42 patients; P value 0.05) and euthyroid goiter (2/60 patients; P value < 0.001). Certain parameters such as high T3, T4 at the time of presentation were associated with higher incidence of these complications, in spite of very well controlled thyrotoxicosis. Whether heightened receptor sensitivity to catecholamines and higher renin-angiotensin activation explain these findings in Graves' disease, remains to be ascertained.
众所周知，甲状腺功能亢进与心血管表现有关。作者注意到，病情得到良好控制的格雷夫斯病患者在手术中常因心血管不稳定而出现问题。对137例格雷夫斯病患者（n = 35）、毒性结节性甲状腺肿患者（n = 42）和甲状腺功能正常的良性甲状腺肿患者（n = 60）的病例记录进行了回顾性分析。在格雷夫斯病中，发现心血管不稳定表现为高血压（n = 9）伴快速心律失常（n = 8）和心动过缓（n = 3）。与毒性结节性甲状腺肿患者可比组（3/42例患者；P值0.05）和甲状腺功能正常的甲状腺肿患者（2/60例患者；P值<0.001）相比，上述3个问题中前2个问题在格雷夫斯病患者（9/35例患者）中的发生率显著更高。尽管甲状腺毒症得到了很好的控制，但某些参数，如就诊时高T3、T4，与这些并发症的较高发生率相关。受体对儿茶酚胺的敏感性增加和肾素-血管紧张素激活增强是否能解释格雷夫斯病的这些发现，仍有待确定。
