实用医学杂志2017，Vol.33Issue(24)：4109-4113,5.DOI:10.3969/j.issn.1006-5725.2017.24.022
甲状腺功能亢进性心脏病临床特点与131I治疗安全处置探讨
Characteristics of hyperthyroid heart disease and radioiodine-131 treatment strategy
摘要
Abstract
Objective To discuss the clinical characteristics of hyperthyroid heart disease(HHD)and ex-plore the strategy to guarantee radioiodine-131 therapy(RAI)safety. Methods Clinical data and treatment regi-mens of 40 HHD patients admitted into our department from 2012-2016 were analyzed. Common complications as atrial fibrillation,heart failure,liver damage incidences and their characteristics were concluded. Curative effects of radioiodine-131 was evaluated. Results The incidence of atrial fibrillation(AF)was 45.0%. Heart failure (HF)of left ventricular ejection fraction(LVEF)was 80.0%.Severity of HF was accompanied with serum brain na-triuretic peptide(BNP)increase and LVEF decrease.Liver function was moderate-medium impaired(61.5%).De-gree of HF was positively correlated with direct bilirubinhe(R = 0.390,P = 0.012). The RAI one-dose cure rate for hyperthyroidism was 77.5%.ATD use before RAI has no effect on the cure rate. Four patients who can′t be treated with ATD deteriorated after RAI,two of them died because of seriously infection and HF,the other two re-covered with saturated solution of potassium iodide or lithium. Conclusion HHD treatment should be made fa-miliar. ATD before RAI treatment can avoid thyroid function impairment. If anti-thyroid medication can not be used on patients,glucocorticoids,saturated solution of potassium iodide or lithium can be applied according to the patients′conditions.关键词
甲状腺功能亢进性心脏病/房颤/心衰/131IKey words
hyperthyroid heart disease/atrial fibrillation/heart failure/radioiodine 131引用本文复制引用
黄蕤,李林..甲状腺功能亢进性心脏病临床特点与131I治疗安全处置探讨[J].实用医学杂志,2017,33(24):4109-4113,5.基金项目
四川省科技厅重点研发项目(编号:2017SZ0119) （编号:2017SZ0119）
