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目的提高对老年冠心病患者心脏支架术后合并甲状腺功能减退症(甲减)的认识。方法对我院1例老年冠心病心脏支架置入术后合并甲减患者的误诊误治过程行回顾性分析。结果本例为老年男性,冠心病心脏支架术后因不典型心绞痛症状入我院,入院后心电图提示心肌缺血,磷酸肌酸激酶增高,诊断急性冠状动脉(冠脉)综合征,但治疗效果差,多次行心肌酶谱及心电图检查无动态演变规律。后经甲状腺B超及甲状腺功能检查确诊甲减,甲状腺素替代治疗效果佳。结论老年冠心病患者在心脏支架置入术后并发甲减时,因磷酸肌酸激酶增高,很容易误诊为急性冠脉综合征,动态观察磷酸肌酸激酶的变化规律,及时检查甲状腺功能,可减少误诊。
Objective To improve the understanding of hypothyroidism (hypothyroidism) in elderly patients with coronary heart disease after cardiac stenting. Methods A retrospective analysis was performed on the misdiagnosis and mistreatment of one case of elderly patients with coronary heart disease complicated with hypothyroidism undergoing cardiac stent implantation. Results In this case, elderly male patients were admitted to our hospital due to atypical angina pectoris after coronary stenting. Post-hospital electrocardiogram showed myocardial ischemia and increased creatine phosphokinase, and the diagnosis of acute coronary syndrome (ACS) Poor, multiple myocardial enzymes and ECG without dynamic evolution. After the thyroid B and thyroid function tests confirmed hypothyroidism, thyroid hormone replacement therapy good effect. Conclusions Elderly patients with coronary heart disease may be misdiagnosed as acute coronary syndromes when their hypothyroidism is complicated by cardiac stent implantation. The changes of creatine phosphokinase can be dynamically observed and thyroid function can be examined in time. Reduce misdiagnosis.