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患者,女性,37岁。停止哺乳后持续溢乳8年,畏寒、纳差、全身浮肿、便秘4年。病后月经周期及经量均正常,无口服避孕药史,否认肝脏病史。12年前曾因甲状腺机能亢进行甲状腺次全切除术。查体:皮肤干燥粗糙,呈非可凹性浮肿,面容虚肿,舌大唇厚,发音如蛙声,颈部可见手术疤痕,甲状腺不肿大。两侧乳房触发性溢乳。心音低钝,心率60。跟腱反射松弛时间延长。心电图示:窦性心率,Ⅱ°房室传导阻滞。超声心动图示:左室后壁活动减弱。两侧视野无缺损。头颅CT扫描未见异常。实验室检查:甲状腺摄~(131)Ⅰ率2小时、6小时、24小时分别为5.6％、8.2％、12.0％,T_3>0.5μg/L、T_4<20μg/L,TSH>8.1mu/L,TMA、TGA均阴性。PRL60μg/L(正常22～3μg/L),甘油三脂6.33mmol/L、β脂蛋白37.5mmol/L。胆固醇8.375mmol/L,肝功能TTT13u、ZnTT17u。入院诊断原发性甲状腺功能减低合并乳溢症。给予甲状腺片治疗,症状逐渐
Patient, female, 37 years old. After stopping breast-feeding continued galactorrhea 8 years, chills, anorexia, body edema, constipation 4 years. After menstruation, the menstrual cycle and the amount of normal, no history of oral contraceptives, denied the history of liver disease. 12 years ago due to hyperthyroidism subtotal thyroidectomy. Physical examination: dry and rough skin, non-concave concave swollen, swollen face, tongue lips thick, pronounced as a frog, the neck visible surgical scars, thyroid does not enlarge. Breast triggering galactorrhea on both sides. Low heart sound, heart rate 60. Achilles tendon reflex relaxation time extension. ECG shows: sinus heart rate, Ⅱ ° atrioventricular block. Echocardiography: Left ventricular posterior wall activity weakened. Both sides of the field of vision without defect. Skull CT scan showed no abnormalities. Laboratory tests showed that T_3> 0.5μg / L, T_4 <20μg / L and TSH> 8.1mu / L were significantly higher in thyroid uptake of 131I at 2 hours, 6 hours and 24 hours respectively , TMA, TGA were negative. PRL 60μg / L (normal 22 ~ 3μg / L), triglyceride 6.33mmol / L, β lipoprotein 37.5mmol / L. Cholesterol 8.375mmol / L, liver function TTT13u, ZnTT17u. Admission diagnosis of primary hypothyroidism combined with milk overflow syndrome. Give thyroid tablets treatment, the symptoms gradually