原发性甲状旁腺功能亢进症84例心电图特征分析

摘要

Objective: To analyze the electrocardiographic (ECG) characteristics in patients with primary hyperparathyroidism (PHPT) and meanwhile, to explore the relationship between ECG abnormality and serum calcium level in relevant patients. Methods: Our study included 2 groups: Observation group,n=84 PHPT patients treated in our hospital from 2010-01 to 2014-04 and Control group,n=80 normal subjects from regular physical examination at the same period. The ECG manifestation was compared between 2 groups. Meanwhile, according to tertile levels of serum calcium, PHPT patients were further divided into 3 subgroups:①Ca2+ level (2.0-2.8) mmol/L,②Ca2+ level (2.8-3.1) mmol/L,③Ca2+ level >3.1 mmol/L andn=28 in each subgroup. The ECG abnormalities were compared among 3 subgroups and the relationship between ECG changes and serum calcium levels were studied. Results: The ECG abnormality rates in Observation group and Control group were as 83.3% vs 18.8%, P<0.001. Compared with Control group, Observation group presented more frequent ST-T changes, QRS duration widening, high left ventricular pressure and QT interval shortening,P<0.001 orP<0.05. In observation group, with the rising of serum calcium, the incidences of ST-T changes and high left ventricular pressure were increased accordingly, the ST-T changes among 3 subgroups were significant,P<0.05; while with the rising of serum calcium, the QT interval was shortened and QRS duration was widened accordingly, the differences were obvious among 3 subgroups, allP<0.05.Conclusion: PHPT patients have the higher incidence with abnormal ECG, while ECG abnormality has beenrelated to serum calcium level in relevant patients.%目的:分析原发性甲状旁腺功能亢进症(PHPT)患者的心电图表现,并与正常人心电图作对比,同时探讨心电图异常与血钙水平的关系.方法:收集我院2010-01至2014-04期间收治的84 例PHPT患者为观察组,另选择同期健康体检的成人80例作为对照组,比较两组受检者的心电图异常情况;同时根据血钙(Ca2+)三分位水平将观察组患者分为3个亚组,即血Ca2+:2.0~2.8 mmol/L 者28例、2.8~3.1 mmol/L 者28例和>3.1 mmol/L 者28例,比较3个亚组间心电图异常情况.探讨心电图异常与血钙水平关系.结果:观察组心电图异常率为83.3%,对照组异常率为 18.8%,两组比较差异有统计学意义(P<0.001).观察组患者心电图异常情况中,以ST-T段改变、QRS波增宽、左心室高电压及QT间期缩短为主.与对照组相比,观察组上述心电图异常指标差异均有统计学意义(P<0.001或P<0.05).观察组患者随着血钙水平的增高,ST-T段改变、左心室高电压的发生率逐渐增加,且ST-T段改变在3个亚组间比较,差异有统计学意义(P<0.05).而QT间期随着血钙水平增高逐渐缩短,QRS波宽随着血钙水平升高而增宽,3个亚组间比较,差异有统计学意义(P均<0.05).结论:PHPT患者的心电图异常率较高,与血钙水平呈正相关.