Study on complication after noncardiac thoracotomy in hypothyroidism with ST segment change patients / 中国地方病学杂志

ABSTRACT

Objective To investigate complications in patients after noncardiac thoracotomy in hypothyroidism with ST changes. Methods Sixty one patients with hypothyroidism undergoing noncardiac thoracotomy were divided into ST segment change group(28 patients having ST segment depression≥0.05 mV) and controls(33 patients) according to the results of Holter. All patients were added with thyroid hormone, until the function of thyroid gland was normal before thoracotomy. The myocardial ischemia was measured by Holter within 48 hours after thoracotomy. Serum thyroid hormones was examined by radioimmunoassay during, before and after thoracotomy. And cardiovascular events were foliowed-up to hospital. Results Before and after thoracotomy serum TT3 in ST segment change group was (1.30±0.41), (2.09±0.45)nmol/L, TT4 was (80.56±30.28), (84.55±33.57) nmol/L, respectively; compared with the control group[TT3 (1.43±0.52), (2.38±0.51)nmol/L, TT4(82.70± 29.43), (93.47±35.02)nmol/L], no significant differences were found(all P>0.05). After thoracotomy, 24 patients occurred myocardial ischemia, 10 patients occurred cardiovascular events in ST segment change group; 8 patients occurred myocardial ischemia, a patient occurred cardiovascular events in control group, there were significant differences between two groups(χ2=22.95,10.95, all P<0.05). The positive predictive value of ST segment change in Holter detection was 36% (10/28) recording in cardiovascular events of patients with cardiovascular disease undergoing noncardiac thoracotomy and hypothyroidism, negative predictive value was 97%(32/33). Conclusions Myocardial ischemia and other cardiovascular events tend to occur in hypothyroidism patients with ST segment change after noncardiac thoracotomy. ST segment change of preoperative Hoher detection recording cardiovascular events of hypothyroidism patients undergoing noncardiac thoracotomy has certain predictive value.