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患者,女,50岁,八年前出现畏寒、怕冷和全身浮肿,当时血清T_3 1.3nmol/L,T_4 19.3nmol/L,TSH62mu/L,诊断为原发性甲状腺机能减退症,以甲状腺片100mg/日替代治疗后,症状消失,血清T_3、T_4 及TSH 均恢复正常水平。一年前,患者出现膝关节以下骨痛,并逐渐发展为全身酸痛,活动时更甚,无麻木感和抽搐现象。先后用强的松、布洛芬治疗,疗效欠佳。病人已绝经三年。体检:血压16/10kPa,无浮肿,双侧甲状腺Ⅱ度,无明显结节感,右甲状腺区下极可扪及一个3×3cm 左右的包块,质较韧,与周围组织界限不清,无压痛,随吞咽上下活动。无肌肉萎缩,关节无红肿及畸形。
Patients, female, 50 years old, eight years ago, chills, cold and body edema, serum T_3 1.3nmol / L, T_4 19.3nmol / L, TSH62mu / L, diagnosed as primary hypothyroidism, thyroid 100mg / day replacement therapy, symptoms disappeared, serum T_3, T_4 and TSH returned to normal levels. A year ago, patients developed pain in the knee and developed into generalized aches and pains. Their activities even worsened. They showed no numbness and convulsions. Has used prednisone, ibuprofen treatment, poor efficacy. The patient has been menopause for three years. Physical examination: blood pressure 16 / 10kPa, no edema, bilateral thyroid Ⅱ degree, no obvious nodules, the right thyroid area palpable under the pole and a 3 × 3cm mass, relatively tough quality, and the surrounding tissue boundaries, No tenderness, up and down with swallowing activity. No muscle atrophy, joint swelling and deformities.