97例甲状腺功能减退症的临床特征及治疗与预后研究

目的分析甲状腺功能减退症的临床特征及治疗、预后,为临床工作提供借鉴资料。方法选择巴中市中心医院2008年6月～2012年12月诊治的97例甲状腺功能减退症患者作为研究对象,将患者按照治疗方案分为两组,对照组45例采用甲状腺片治疗,观察组52例采用左甲状腺素钠（优甲乐）治疗,回顾性分析患者的临床特征,临床检查以及并发症特点,观察两组患者的治疗预后。结果研究对象的血清游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）均降低,促甲状腺激素（TSH）均增高,部分患者心脏彩超异常,容易合并骨质疏松症、类风湿关节炎等疾病;观察组治疗总有效率为98.1%（51/52）,明显高于对照组的84.4%（38/45）,差异有统计学意义（P〈0.05）;治疗后两组FT3、FT4、TSH均优于治疗前,差异有统计学意义（P〈0.05）;观察组治疗后FT3、FT4、TSH对照组比较,差异有统计学意义（P〈0.05）。结论医务工作者应熟悉甲状腺功能减退症的临床特征,避免漏诊、误诊,并根据患者疾病特点制定有效的用药方案,改善治疗预后。

Study on the clinical features and treatment,prognosis of 97 cases with hypothyroidism

Objective To analyze the clinical features and treatment prognosis of hypothyroidism,and to provide refer ence data for clinical work.Methods From June 2008 to December 2012 in Central Hospital of Bazhong City,97 cas es of hypothyroidism were selected and divided into control group and observation group according to treatment pro grams,45 cases of the control group were treated by Thyroid tablets,52 cases of the observation group were treated by Levothyroxine sodium（Euthyrox） treatment the clinical data of patients,the clinical examination and characteristics of complications were analyzed retrospectively,the treatment and prognosis of patients were observed.Results The serum free triiodothyronine（FT3）,free thyroxine（FT4） of subjects were decreased,and the thyroid stimulating hormone（TSH） were increased,abnormal echocardiography was found in some patients,and it was easy to merge osteoporosis,type rheumatoid arthritis and other diseases;the total effective rate of observation group was 98.1%（51/52）,it was high er than that of control group 84.4%（38/45）],the difference was statistically significant（P 0.05）;after treatment,the serum FT3,FT4 of two groups increased,and TSH reduced,FT3,FT4,TSH in observation group were found had statistically significant differences with control group（P 0.05）.Conclusion Medical workers must be familiar with the clinical features of hypothyroidism,can avoid missed diagnosis and misdiagnosis,and make effective treatment options based on the patient＇s disease characteristics and improve treatment prognosis.