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目的:提高对甲亢患者的诊治水平,减少误诊率。方法:依据甲亢患者临床表现,回顾性分析误诊病例与甲亢产生多系统表现的可能机制。结果:32例中有22例在首诊时误诊,误诊率68.7%,其中,男性,尤其是老年男性患者,主要以消瘦,营养不良性贫血,失眠,心房纤颤,腹泻,呕吐,低钾周瘫,白血球减少误诊;女性主要以心悸,经量减少或闭经,慢性腹泻,类风湿性关节炎误诊。结论:甲亢患者可出现多系统临床表现,误诊与病程长短、性别及年龄,高代谢不明显,突眼少见,甲状腺肿大不明显有关。因此,对一些不典型的甲亢患者,及时行甲状腺功能检查。
Objective: To improve the diagnosis and treatment of hyperthyroidism patients, reduce the misdiagnosis rate. Methods: Based on the clinical manifestations of patients with hyperthyroidism, we retrospectively analyzed the possible mechanism of misdiagnosis cases and hyperthyroidism producing multi-system manifestations. Results: Twenty-two out of 32 cases were misdiagnosed at the first visit, with a misdiagnosis rate of 68.7%. Among them, males, especially elderly males mainly included weight loss, malnutritional anemia, insomnia, atrial fibrillation, diarrhea, vomiting, Week paralysis, white blood cells to reduce misdiagnosis; women mainly palpitations, menstrual flow reduction or amenorrhea, chronic diarrhea, rheumatoid arthritis misdiagnosis. Conclusions: The multi-system clinical manifestations may occur in patients with hyperthyroidism. Misdiagnosis and duration of disease, gender and age, high metabolism are not obvious, exophthalmos is rare, and goiter is not obvious. Therefore, some patients with atypical hyperthyroidism, timely thyroid function tests.