老年甲状腺功能减退症的临床特征及治疗策略  

Clinical analysis and therapeutic options of old aged hyperthyroidism

作　　者：王卫民[1] 

机构地区：[1]河南省商丘市第一人民医院内分泌科,476100

出　　处：《中国实用医药》2013年第5期41-42,共2页China Practical Medicine

摘　　要：目的总结老年甲状腺功能减退症患者的临床表现、实验室检查及治疗策略,为临床诊治老年甲状腺功能减退症提供临床经验。方法回顾性分析我院内分泌科自2002年3月至2011年4月诊治的老年甲状腺功能减退症患者138例,观察患者的临床表现及实验室检查结果特征,并分析治疗效果。结果①心悸、胸闷、气短76例,乏力93例,纳差31例、便秘19例,畏寒怕冷58例,贫血47例,心动过缓37例,全身性水肿31例,甲状腺肿大31例。②实验室检查:TC:(4.6±1.4)mmol/L,TG:(1.4±0.4)mmol/L,LDL:(2.1±1.3)mmol/L;TT3:(1.19±0.30)nmoL/L,TT(4:70.8±26.4)nmoL/L,TSH:(13.2±23.8)nmoL/L。③本组患者治疗痊愈18例,好转13例,总好转率81.6%(31/38)。结论老年人甲减起病隐匿,发展缓慢,临床表现无明显特异性,应及时检查甲状腺功能;采用左甲状腺素替代治疗上应采用小剂量开始。Objective The clinical manifestation,laboratory examination and therapeutic options of old aged hyperthyroidism were summarized, and the summary of experiences of diagnosis in the ohld aged yperthy- roidism were analysized. Methods One hundred and thirty-eight patients of the old aged were selected and ana- lysed, and the characters of clinical manifestation, laboratory examination were observed and the curative effect was analysed,Results （~The clicinal manifestations were palpitation, choking sensation in chest and breathe hard in 76 cases,weak in 93 cases, poor appetite in 31 cases, constipation in 19 cases, intolerance of cold in 58 cases, anaemia in 47 cases, bradyarrhythmia in 37 cases, anasarea in 31 cases and thyroid enlargement in 31 cases. （~） The level of TC was （4. 6 ＋ 1.4） mmol/L, TG： （ 1.4 ~ 0.4） mmol/L, LDL： （2. 1 ~ 1.3 ） retool/L; TY3 ： （ 1.19 ~ 0. 30 ） nmoL/L, Tr （4： 70. 8 ~ 26, 4 ） nmoIVL, TSH： （ 13.2 ~ 23.8 ） nmoL/L; 3 ） The cases of re- covery were 18 and improvement were 13, and the total improvement rate was 81.6% （31/38）. Conclusion The characters of old aged hyperthyroidism are Onset hidden, development slowness and no feature of clinical manifestation, and the examination of thyroid function is needed and the thyroid replacement therapy is applied with small dose.

关 键 词：甲状腺功能减退症 老年 临床表现 替代治疗 

分 类 号：R581.2[医药卫生—内分泌]