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甲状腺功能亢进症临床表现回顾性分析 总被引:2,自引:0,他引:2
198 8年 1月至 2 0 0 2年 10月 ,我院收治甲状腺功能亢进症 (甲亢 ) 2 2 6例 ,现将其临床表现、误诊疾病、治疗情况作一回顾性分析并报道如下。1 临床资料1.1 一般资料 所有病例均符合甲亢诊断标准[1 ] ,男 6 8例 ,女 15 8例 ;年龄 15~ 86岁 ,平均 4 4 .2岁 ,其中 <2 5岁 2 1例(9 .3% ) ,2 5~ 4 4岁 113例 (5 0 .0 % ) ,4 5~ 5 9岁 5 8例(2 5 .7% ) ,6 0岁以上 34例 (15 .0 % ) ;男∶女 =1∶2 .32 ;病程 7天至 4 0年 ,3年以下 12 7例 ,3年以上 99例。1.2 主要临床表现 12 9例有明显高代谢症侯群 ,占5 7.1% ,以心悸、消瘦、多汗、多… 相似文献
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非心脏手术患者伴有心功能异常 ,是临床上经常遇到的问题 ,直接影响到手术的成败、术中操作及术后康复。但由于常规心电图记录时间短 ,不能反映心电异常的全貌 ,尤其是对阵发性、复杂性及恶性心律失常、阵发性心肌缺血、复合性心电异常 ,ECG既不能确定质和量 ,又容易出现误诊和漏诊 ,为弥补其不足 ,本组对 12 0例在围手术期给予 ECG及 DCG监测 ,并进行对比分析如下。1 对象和方法1.1 对象 本院 1992 - 0 8~ 2 0 0 1- 0 8,住院准备施手术的患者 ,共计 12 0例 ,其中男 6 9例 ,女 5 1例 ,年龄 2 9~ 90岁 ,平均 5 7.35岁± 10 .5 6岁。… 相似文献
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[目的]探讨动态心电图分析长RR间期的临床价值.[方法]对85例动态心电图检查结果出现长RR间期(RR≥2 000 ms)者结合其日常生活日志进行回顾性分析.[结果]85例患者出现长RR的状况如下:①长RR间期可出现在房颤伴长RR 33例,窦性停搏15例,窦房传导阻滞12例,房室传导阻滞(包括Ⅰ度、Ⅱ度、Ⅲ度及高度房室传导阻滞)26例,早搏后长代偿8例;②最长RR可达8.68 s;③长RR间期多见于夜间睡眠期(0:00~5:00)及白天休息期(12:00~14:00),活动及清醒期比较少见;④长RR>3 000 ms时患者会出现黑曚、晕厥甚至抽搐.[结论]动态心电图长RR分析对于减少临床上心源性猝死是简单有效的预测方法. 相似文献
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【目的】比较电话传输心电图(TTM)与动态心电图(DCG)对心律失常、心肌缺血的检出率,比较两者在临床应用上的优缺点,为临床合理使用TTM提供指导。【方法】采取自身对照,对比分析80例因心悸、胸闷、胸痛等不适住院患者的TTM及DCG检出结果。【结果】①TTM对偶发房性早搏、偶发室性早搏及ST-T改变的检出率比DCG高(P〈0.05);②TTM对频发房性早搏、频发室性早搏、短阵房性心动过速、阵发性心房颤动、短阵室性心动过速、高度房室传导阻滞的检出率与DCG差异无显著性(P〉0.05);③TTM可随时随地将病人的心电信息发送到医院监护中心,及时对所发生的心血管事件进行处理;④少数TTM图形欠清晰,自动化分析结果有偏差,需通过人工分析补充完善。【结论】TTM对发作元规律、间歇发作、持续时间短暂的心律失常及一过性心肌缺血有独到价值,非常适合心律失常、心肌缺血突发事件高危人群的院外监护。 相似文献
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目的 探讨老年眼科常见疾病患者动态心电图检查临床分析.方法 分析309例老年眼科常见疾病患者动态心电图.结果 309例老年眼科常见疾病患者动态心电图异常者70例,占总数的68%.结论 老年眼科常见疾病术前动态心电图检查发现心律失常及ST-T波异常改变,应引起重视,积极控制血压、血糖,营养心肌,常规给予术中、术后心电监护,以确保手术期的安全. 相似文献
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目的 探讨口服索他洛尔对甲状腺机能亢进 (甲亢 )性心房颤动 (Af)的疗效及安全性。方法 对 4 8例甲亢持续性Af的患者常规华法林钠 (商品名 :华法林 ) (2 .5mg/d)抗凝 3周后给予口服索他洛尔 ,第 1周 80mg/d ,第2周起 1 6 0mg/d ,治疗 2~ 4周。对比分析用药前后血压、心率、心电图QT间期 (QTc)、QRS时限 (QRSd)、左心房内径 (LAD)、左心室舒张期内径 (LVDd)、左心室射血分数 (LVEF)及短轴缩短率 (LVFS)的变化 ,并观察比较复律与未复律患者间年龄、甲亢病史、LAD、LVDd、房颤f波频率 (Aff)与最大f波振幅 (Afmax)的差异。结果 转复成功率为70 .84 % (34/ 4 8) ,平均转复时间为 (2 0 6± 5 6 )小时 ,平均转复用药量为 (81 8± 1 0 3)mg/人。临床有效率 97.92 % (4 7/4 8) ,治疗前后的LVDd、LVEF、LVFS、QRSd差异无统计学意义 (P >0 .0 5 ) ,收缩期血压 (SBP)与心率下降明显 (P <0 .0 1 )。QTc用药后明显延长 (P <0 .0 1 ) ,但仅有 1例 (2 .0 8% ) >5 2 0ms而停药。 2例因SBP <90mmHg(1mmHg=0 .1 33kPa)而停药 (4 .1 7% )。复律 34例患者中有 3例在半年内复发Af,复发率为 8.82 % (3/ 34)。复律与未复律患者间年龄、甲亢病史、Af持续时间、LAD、LVDd、Aff 与Afmax的比较结果显示差异均具有统计学意义 (P < 相似文献
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自主神经功能指标对心脏性猝死的预测价值 总被引:1,自引:0,他引:1
目的探讨自主神经功能指标(心率变异性及心率震荡)对心脏性猝死(SCD)患者的预测价值。方法对江西省人民医院门诊及住院的50例猝死高危患者(猝死高危组)进行前瞻性随访研究,同时选择无明显器质性心脏病史的患者50例作为对照组。2组患者均采用24h动态心电图进行检测,分析心率变异性的24h正常窦性RR间期的标准差时域指标(SDNN)、窦性心率震荡的心率起始(TO)和心率斜率(TS)指标的变化,3个月随访1次,持续2年。猝死高危组根据是否发生终点事件分为恶性心律失常组(12例)及非恶性心律失常组(38例)。以SCD或室颤作为终点事件,对上述数据进行统计学分析。结果猝死高危组中12例患者发生SCD(冠心病6例,扩张性心脏病5例,长QT综合征1例)。猝死高危组SDNN、TS均明显低于对照组,TO高于对照组(均P〈0.05)。恶性心律失常组的TS明显低于非恶性心律失常组(P〈0.05);2组SDNN及TO比较差异均无统计学意义(均P〉0.05)。结论猝死高危患者TS低于对照组,且与恶性心律失常的发生关系密切。TS可能是SCD预测的重要指标。 相似文献
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Autonomic Function Testing in Patients with Migraine 总被引:2,自引:0,他引:2
T. Pogacnik M.D. Ph.D. S. Sega M.D. M.Sc. B. Pecnik M.D. T. Kiauta M.D. Ph.D. 《Headache》1993,33(10):545-550
SYNOPSIS
Autonomic nervous system function was studied in 62 patients with migraine. The Valsalva maneuver, deep breathing test, sustained handgrip test, orthostatic test and spectral analysis of heart rate variability in the supine and standing positions were performed in a group of 62 patients of both sexes, aged 21 to 50 years, and in an age-matched control group of 45 healthy volunteers.
Heart rate increase during sustained handgrip was significantly reduced in the headache group, when compared to the control group, while the results of the remaining cardiovascular tests did not significantly differ between the control and headache groups. In standing patients, the integrals of middle frequency bands of amplitude spectra were smaller in patients than in controls because the increase induced by standing was smaller in migraine patients. The results in patients with migraine with aura (21 patients) and migraine without aura (41 patients) did not differ significantly from each other. The same was true for the results of the female and male patients.
It is concluded that sympathetic function is impaired in migraine patients. 相似文献
Autonomic nervous system function was studied in 62 patients with migraine. The Valsalva maneuver, deep breathing test, sustained handgrip test, orthostatic test and spectral analysis of heart rate variability in the supine and standing positions were performed in a group of 62 patients of both sexes, aged 21 to 50 years, and in an age-matched control group of 45 healthy volunteers.
Heart rate increase during sustained handgrip was significantly reduced in the headache group, when compared to the control group, while the results of the remaining cardiovascular tests did not significantly differ between the control and headache groups. In standing patients, the integrals of middle frequency bands of amplitude spectra were smaller in patients than in controls because the increase induced by standing was smaller in migraine patients. The results in patients with migraine with aura (21 patients) and migraine without aura (41 patients) did not differ significantly from each other. The same was true for the results of the female and male patients.
It is concluded that sympathetic function is impaired in migraine patients. 相似文献
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目的 :运用三维彩色多普勒超声计算扩张性心肌病患者心搏出量 ,探讨彩色三维超声在左室扩张变形时的应用价值。方法 :扩张性心肌病患者 9例 ,男 6例 ,女 3例 ,以二维 M-型超声心动图计算左室射血分数(EF)、短轴缩短率 (FS)及每搏量 (SV) ;运用三维彩色多普勒超声仪对患者主动脉瓣口血流进行三维重建 ,计算每搏量并与二维超声测值比较。结果 :二维超声测值 EF:2 8.2 %± 3.8% ,FS:1 3.7%± 1 .9% ,每搏量 :(56.1± 1 0 .4) ml;三维超声测值每搏量 :(47.5± 1 2 .8) ml。二维与三维超声的每搏量测值 t检验无显著性差异。结论 :彩色三维超声心动图可不受左室形变及二尖瓣返流的影响 ,能较准确地评价扩张性心肌病患者的每搏量及心功能状况 相似文献
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目的观察心脏抑制型血管迷走性晕厥(vasovagal syncope,VVS)病人倾斜试验中的反应模式及自主神经变化.方法分析6例心脏抑制型晕厥(cardioinhibitory vasovagal syncope,CI)病人(平均年龄27岁±11岁)和8名健康者(平均年龄26岁±5岁)倾斜试验过程中的心率、血压及心率变异性功率谱变化.结果CI组病人倾斜后心率达高峰后急剧下降,随之发生晕厥.CI组心率下降百分比显著高于对照组(P<0.01),两组平均动脉压无明显变化.CI组晕厥前低频与高频功率的比值(LF/HF)和低频段功率的标化值(LFnorm)增加,晕厥时两者均显著下降,而高频段功率的标化值(HFnorm)明显增加;而对照组功率谱变化幅度远小于CI组.结论自主神经失调引起的心率急剧改变是心脏抑制型病人发生晕厥的特点. 相似文献
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目的探析胆石症患者动态心电图临床情况。方法选取我院2003年10月-2006年10月收治的不同年龄阶段患胆囊结石症患者325例。对这些患者的动态心电图和临床的症状进行分析研究。结果胆囊结石症患者ST-T异常的发生率及心律失常:无心血管疾病组(P〈0.05)低于合并心血管疾病组,合并心血管疾病的青年组(P〈0.05)低于中年组,合并心血管疾病的中年组又低于老年组。结论合并心血管疾病的老年胆囊结石症患者的ST-T及心律失常的发生率比较高。 相似文献
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Tomaz Pogacnik M.D. Ph.D. Sasa Sega M.D. M. Sc. Anton Mesec M.D. Ph.D. Tomaz Kiauta M.D. Ph.D. 《Headache》1993,33(2):63-68
SYNOPSIS
Autonomic nervous system function was studied in 51 patients with tension-type headache. The Valsalva manoeuvre, deep breathing test, sustained handgrip test, orthostatic test and spectral analysis of heart rate variability in the supine and standing positions were performed in a group of 51 patients of both sexes aged 21 to 50 years and in an age-matched control group of 45 healthy volunteers.
Diastolic blood pressure increase and particularly heart rate increase during sustained handgrip were significantly reduced in the headache group, when compared to the control group, while the results of the remaining tests did not significantly differ between the control and headache groups. No significant differences were found between the episodic (19 patients) and chronic (32 patients) tension-type headache subgroups.
It is concluded that sympathetic function is impaired in tension-type headache patients. 相似文献
Autonomic nervous system function was studied in 51 patients with tension-type headache. The Valsalva manoeuvre, deep breathing test, sustained handgrip test, orthostatic test and spectral analysis of heart rate variability in the supine and standing positions were performed in a group of 51 patients of both sexes aged 21 to 50 years and in an age-matched control group of 45 healthy volunteers.
Diastolic blood pressure increase and particularly heart rate increase during sustained handgrip were significantly reduced in the headache group, when compared to the control group, while the results of the remaining tests did not significantly differ between the control and headache groups. No significant differences were found between the episodic (19 patients) and chronic (32 patients) tension-type headache subgroups.
It is concluded that sympathetic function is impaired in tension-type headache patients. 相似文献
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MAARTEN P. VAN DEN BERG ANDRIES J. SMIT 《Pacing and clinical electrophysiology : PACE》1997,20(8):2039-2042
The factors that determine the individual susceptibility to vasovagal syncope (VVS) are largely unknown, including the role of the autonomic nervous system. We therefore studied common vagal and sympathetic reflexes in 12 patients with WS (mean age 37 (18–75) years, 6 men). The Valsalva maneuver and deep breathing were performed to assess vagal responsiveness and mental arithmetic stress; the cold-pressor test and isometric handgrip were performed to assess sympathetic responsiveness. Standing up was performed to assess the combined responsiveness. With the exception of a subnormal response to deep breathing in one patient, all vagal tests were normal. In contrast, the response to mental stress, the cold-pressor test, and isometric handgrip was subnormal in 4 patients, 6 patients, and 4 patients, respectively. The response to standing up was normal in all patients. It is concluded that many patients with WS are characterized by normal vagal responsiveness, but sympathetic hyporesponsiveness. Sympathetic hy-poresponsiveness might explain the inadequate vasoconstriction, which plays an important, early role in WS. 相似文献
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目的分析总结原发性甲状腺功能亢进症(甲亢)的损伤机制和误诊原因。方法对我院1999~2009年收治并误诊的44例原发性甲亢的临床资料进行回顾性分析。结果本组误诊为冠心病9例,肠易激综合征及慢性结肠炎8例,多发性肌炎6例,心肌炎、更年期综合征各5例,周期性瘫痪3例,特发性水肿、心律失常及焦虑、抑郁各2例,精神分裂症及药物性肝损害各1例。44例均经放射性131I和甲状腺功能检查确诊为原发性甲亢。确诊后予抗甲状腺治疗,其中24例同时使用升白细胞药物,8例同时使用保肝药物治疗。44例治疗4~8周后症状、体征均明显缓解,甲状腺功能恢复正常;出院后抗甲状腺药物减量维持12~24月,29例长期缓解,15例行131I治疗。结论原发性甲亢临床表现复杂多样,症状不典型者易误诊,对高度怀疑该病者,应及时行甲状腺功能检查,以早期诊断及治疗。 相似文献
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吲哒帕胺对高血压病患者心功能康复的影响 总被引:1,自引:0,他引:1
目的 探讨吲哒帕胺对高血压病患者的疗效及对心功能的影响。方法 56例高血压病患者随机分为氢氯噻嗪组和吲哒帕胺组,分别应用氢氯噻嗪和吲哒帕胺治疗,并辅以合理膳食、控制体重等常规非药物治疗;治疗前与治疗2个月后采用超声心动图评定两组患者的心功能。结果 治疗后,两组患者的射血分数提高,左心室相对厚度下降(P〈0.05),但吲哒帕胺组的效果优于氢氯噻嗪组(P〈0.05)。结论 吲达帕胺改善心脏功能与结构的效果优于氢氯噻嗪。 相似文献