患者，女，３６岁。因怕热、多汗、心悸、消瘦伴颈粗一个月余在某镇医院诊为“甲亢”，口服甲硫咪唑等药物治疗，２周之后，病人出现怕冷、浮肿及体重增加，转我院就诊。体格检查：体温３６．８℃，甲状腺Ⅱ度弥漫性肿大、轻度压痛、无血管杂音，突眼征阴性。ESR显著增快，甲状 Patient, female, 36 years old. Fear of heat, sweating, palpitations, weight loss with neck rough more than a month in a town hospital diagnosed as “hyperthyroidism”, oral methimazole and other drug treatment, 2 weeks later, the patient appeared afraid of the cold, edema and weight gain, turn me Hospital treatment. Physical examination: body temperature 36.8 ℃, diffuse enlargement of the thyroid Ⅱ degree, mild tenderness, no vascular murmur, exophthalmos levy negative. ESR significantly faster, thyroid