84例成人甲状腺机能减退性肌病临床荟萃分析  

Clinical meta-analysis of eighty-four cases of hypothyroid myopathy in adults

作　　者：郑东辉[1] 莫颖倩[1] 戴冽[1] 张白玉[1] 苏剑华[1] 

机构地区：[1]中山大学附属第二医院风湿免疫科,广东广州510120

出　　处：《国际内科学杂志》2009年第9期497-500,504,共5页International Journal of Internal Medicine

摘　　要：目的了解成人甲状腺机能减退性肌病的临床特点,提高对该病的认识。方法回顾分析1994年至2007年国内相关文献报道及中山大学附属第二医院收治的共84例甲状腺机能减退性肌病患者的临床资料。结果本组84例患者中多发性肌炎样综合征占64.3%,Hoffmann综合征占26.2%,不伴肌强直的肥大性肌病、不伴肌肥大的肌强直及肌萎缩3者共占9.5%。多发性肌炎样综合征患者都有四肢近端肌无力,57.7%有肌痛,33.3%肌电图显示肌源性损害,30%的患者肌活检见肌纤维肿胀断裂,40%有炎性细胞浸润。Hoffmann综合征患者都有肌肥大,68.4%有肌僵硬,36.8%的患者活动后有局部肌球形成,肌电图显66.7%示肌源性损害,16.7%出现肌强直(样)电位。所有患者甲状腺素替代治疗后症状消失,肌酶及甲状腺功能指标恢复正常。结论甲状腺机能减退性肌病分为不同临床类型,表现多样,预后好,甲状腺素替代治疗可治愈。临床对有肌病表现的患者应注意甲状腺机能减退性肌病。Objective To improve the understanding of hypothyroid myopathy in adults. Methods Clinical data of 84 cases of hypothyroid myopathy were reviewed retrospectively. Results Polymyositis-like syndrome （64. 3% ） and Hoffmann syndrome（26. 2% ） were common subsets of hypothyroid myopathy and the other three types（ hypertrophic myopathy without myotonia, myotonia without muscle hypertrophy and muscle wasting） were rare （9. 5% ）. Polymyositis-like syndrome was characterized as weakness （100%） and myalgia （57. 7% ）. Electromyography showed that 33. 3% patients had myopathic injury. Muscle biopsy revealed that 40% patients had inflammation and 30% showed swelling and broken muscle fibers. Hoffmann syndrome was characterized as muscle hypertrophy （100%）, stiffness （68.4%） and muscle prominence （36. 8% ）. Electro- myography showed 66. 7% patients had myopathic injury, while 16. 7% showed myotonic potential. All patients showed clinical recovery and resolution of the laboratory indexes abnormalities after thyroid hormone replacement. Conclusions Hypothyroid myopathy has different clinical subsets which is treatable with thyroid hormone replacement. Hypothyroidism should be routinely screened in patients with myopaby.

关 键 词：甲状腺机能减退症 甲状腺机能减退性肌病 多发性肌炎样综合征 Hoffmann综合征 

分 类 号：R581.2[医药卫生—内分泌]