以肌损害为主要表现的原发性甲状腺功能减退症五例

目的提高对重症原发性甲状腺功能减退症伴随肌病患者临床特征、病变特点及其治疗的认识。方法回顾性分析1996年3月至2003年11月收治的5例重症原发性甲状腺功能减退伴肌损害患者的临床资料及治疗转归,并结合相关文献对该病的临床特点进行分析。结果5例患者突出的临床表现为对称性近端肌无力、气短、胸痛、呼吸及吞咽困难。血肌酸激酶均显著增高(2 885~10 450 U/L)。结论应将伴有肌损害的原发性甲状腺功能减退症患者与多发性肌炎鉴别,及时给予甲状腺激素替代治疗对甲状腺功能减退相关性肌病有较好疗效。

Clinical analysis for five cases of primary hypothyroidism with main manifestations of muscular damage

Objective To improve the understanding of clinical features,pathological changes and therapy in patients of severe primary hypothyroidism accompanied with myoapthy.Methods Clinical features and prognosis of five cases of primary hypothyroidism accompanied with severe myopathy admitted to the hospital during March 1996 to November 2003 were anaylzed retrospectively by medical records combined with review of relevant literatures.Results Prominent clinical manifestations of the five patients were muscular damage,symmetrical proximal weakness of the muscles(myasthenia),shortness of breath,chest pain,dysphagia,and significant increase in activity of serum creatine phosphokinase(2 885~10 450(U/L).)Conclusions Patients of primary hypothynoidism with muscular damage should be diffrentiated from those of polymyositis and better effectiveness can be achieved for its related myopathy by timely thyroid hormone replacement therapy.