原发性甲状腺功能减退所致精神障碍临床特征分析  

Analysis on clinical characteristics of primary hypothyroidism-induced mental disorder

作　　者：傅锦华[1] 魏宏萍[1] 李小娟[1] 

机构地区：[1]湖南省脑科医院精神科,长沙410007

出　　处：《中南大学学报（医学版）》2016年第7期711-714,共4页Journal of Central South University ：Medical Science

摘　　要：目的:总结原发性甲状腺功能亢进手术或131I治疗后出现甲状腺功能减退所致精神障碍的临床特征及早期诊断依据。方法:回顾性分析15例因甲状腺功能亢进经手术或131I治疗后出现原发性甲状腺功能减退所致精神障碍的临床表现,甲状腺功能生化指标。结果:游离三碘甲腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)降低,促甲状腺激素(thyroid-stimulating hormone,TSH)升高,临床症状主要为懒散、乏力、情绪不稳,常伴有记忆智能障碍、行为障碍及幻觉妄想,严重患者存在意识障碍。结论:原发性甲状腺功能减退所致精神障碍具有临床症状的丰富性、多变性,重视既往病史的询问和甲状腺功能检查,对诊断原发性甲状腺功能减退所致精神障碍并不难,但此病易误诊和漏诊。Objective： To summarize the clinical features and early diagnostic evidence for mental disorders due to primary hypothyroidism after primary overactive thyroid surgery or 131I therapy. Methods： The retrospective analysis was conducted on 15 patients in terms of the clinical features with primary hypothyroidism-induced mental disorder after primary overactive thyroid surgery or 131I therap）a The data regarding past history of hyperthyroidism parallel operation or 131I treatment, thyroid function biochemical indexes were collected. Results： The free triiodothyronine （FT3） and free thyroxine （FT4） were decreased, while thyroid- stimulating hormone （TSH） was increased. The clinical symptoms included lazy; fatigue, and mood swings accompanied by mental retardation, behavioral disorders, hallucinations and delusions. Particularly; the severe patients were of disturbance of consciousness. Conclusion： The clinical features of primary hypothyroidism-induced mental disorder are diverseand variable. It is not difficult to diagnose the mental disorder if the attention is paid on the medical history inquiry and thyroid function tests. However, it is easy to be misdiagnosed and missed diagnosis.

关 键 词：原发性甲状腺功能减退症 精神障碍 促甲状腺激素 游离甲状腺素 游离三碘甲腺原氨酸 误诊 

分 类 号：R581.2[医药卫生—内分泌]