甲状腺风暴中心脏性休克的危险因素:一个回顾性和案例系列研究
Kevin Pink1, Aaron C Yee1, Edward T Ha1
1Department of Internal Medicine & Cardiology, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, 11215 USA.
Future cardiology
|October 13, 2023
概括
甲状腺风暴带有心脏性休克的预后不好. 识别BMI,心力衰竭史和升高的亲BNP等危险因素可以帮助分层患者并改善结果.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
背景情况:
- 甲状腺风暴 (TS) 影响了10%的甲状腺毒性病患者.
- 心脏性休克 (CS) 复杂化了1%的TS病例,表明预后不佳.
研究的目的:
- 在甲状腺风暴患者中识别与心脏性休克相关的危险因素.
- 评估甲状腺风暴中心脏性休克的预后影响.
主要方法:
- 对56名患有甲状腺风暴的患者进行了回顾性分析.
- 评估临床数据,包括BMI,心力衰竭史,亲BNP水平,胸部X射线发现和Burch-Wartofsky得分.
主要成果:
- 关联的CS因素包括更高的BMI (p=0.002),心力衰竭史 (OR 8.33,p=0.004),高的亲BNP (p=0.04),胸部X射线上的间歇性胀 (OR 3.33,p=0.01),以及更高的伯奇-沃托夫斯基得分 (62.5vs40,p=0.004).
- 脊髓癌患者住院时间较长 (16.5 vs 4天,p=0.01) 和住院死亡率显著增加 (OR 24.5,p<0.001).
结论:
- 鉴定的风险因素有助于在入院时早期对TS患者的风险分层.
- 基于风险分层的及时治疗干预可能会降低CSTS患者的死亡率.
相关概念视频
Synthesis and Regulation of Thyroid Hormones
4.7K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.7K
Heart Failure I: Introduction
14
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
14
Blood Pressure Imbalances and Circulatory Shock
790
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
790
Psychoneuroimmunology: Cardiovascular Disease
37
Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
A key area of focus in PNI is the relationship between stress and coronary...
37
Increased pulse rate
674
Tachycardia is a condition marked by an abnormally fast or irregular heart rate, surpassing the typical resting rate. In adults, tachycardia is characterized by a pulse rate ranging from 100 to 180 beats per minute. The increased heart rate can result in inadequate blood flow to various body parts, ultimately diminishing the oxygen supply to organs and tissues.
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
674
Functions of Thyroid Hormones
2.8K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.8K


