甲状腺功能亢进症并发严重低血糖反应延诊分析

目的探讨甲状腺功能亢进症(甲亢)并发严重低血糖反应的临床特点、发病机制、误诊原因及防范措施。方法对我院收治的1例甲亢并发严重低血糖反应的临床资料进行回顾性分析。结果患者因怕热、多汗、乏力18年,加重伴心慌、胸闷1月余入院。有甲亢病史18年,入我院后经相关检查诊断为甲亢并甲亢性心脏病,予相应治疗。入院次日患者突发意识丧失、抽搐,经追问病史及血糖检查后诊断为严重低血糖反应,予推注高浓度葡萄糖注射液后症状缓解。结论甲亢并发低血糖反应临床少见,易漏误诊。提高对其防范意识,加强低血糖高危患者血糖监测,可减少误漏诊,降低病死率。

Delayed Diagnosis of Severe Hypoglycemia Accompanied with Hyperthyroidism

Objective To investigate the clinical features, pathogenesis, misdiagnosis reasons and preventions of hy-poglycemia accompanied with hyperthyroidism. Methods Clinical data of a case of hypoglycemia accompanied with hyperthy-roidism in our hospital was retrospectively analyzed. Results The patient was admitted for hyperhidrosis, fatigue and afraid of the heat for 18 years, became worse and accompanied with palpitation and chest congestion over 1 month. He suffered from hyperthyroidism for 18 years. After our hospital received the patient, he was diagnosed with hyperthyroidism and hyperthyroid cardiopathy according to related examinations. Then he was given appropriate treatment. The next day, the patient suddenly lost his consciousness and convulsions appeared. He was diagnosed with severe hypoglycemia by asking history and examining the blood glucose. After treated with high glucose, the symptoms were finally relieved. Conclusion Hypoglycemia accompa-nied with hyperthyroidism is rare in clinic and may be misdiagnosed easily. Clinicians should raise awareness of preventions of this disease, and improve glucose monitoring to reduce the rates of misdiagnosis and mortality.