甲状腺机能减退性心包积液—15例临床分析

分析原发性甲状腺机能减退性心包积液15例。临床特点:平均基础代谢率降低不如单纯甲减明显。积液进展缓慢,部分患者无胸闷、心悸症状,少量积液胸片及心电图还可以正常,易致漏诊,常因浮肿而诊断为慢性肾炎或肾病综合征。甲减表现常不典型,心包积液还可单独存在,易误诊为结核性心包炎。甲状腺功能特点是血清T_4检查及二维超声心动图在本病的诊断中起重要作用。应用甲状腺片治疗,平均积液消失时间为34.7天。

HYPOTHYROID PERICARDIAL EFFUSION:CLINICAL ANALYSIS OF 15 CASES

Fifteen cases of primary hypothyroid pericardial effusion were analysed. The results showed the following clinical features:The decrease of mean basic metabolic rate was so obvious as simple hypothyroidism. Effusion developed gradually, some of the patients had not the symptoms of chest distress and palpitation. Small amount of effusion showed the normal manifestations of X-ray and ECG. So it was easy to miss diagnosis,particularly,some of the patients were misdiagnosed as chronic nephritis or nephrotic syndrome due to edema. The clinical manifestations of hypothyroidism were often atypical,for example,pericardial effusion existed alone so that it was misdiagnosed as TB pericarditis.Thyroid function tests,especially measurement of total serum thyroxine and the twodimensional echocardiogram played an important role in the diagnosis of this disease. The average time of effusion disappearance was only 34.7 days with thyrotherapy.