甲状腺功能减退性肌病合并糖尿病1例报告及文献复习

A Case Report of Hypothyroidism Myopathy with Diabetes and Literatures Review

【目的】提高对甲状腺功能减退性肌病的认识和诊治水平。【方法】报道甲状腺功能减退性肌病1例,并检索2000~2006年中国期刊全文数据库检索国内报道及PUBMED上检索到的国外文献,进行汇总研究,并讨论该病相应进展。【结果】病例为中年男性,合并糖尿病,2周甲状腺激素替代治疗后效果好。共检索到国内报道16例,国外报道若干例,多为男性患者。发病机制可能与遗传、甲状腺机能减退代谢异常以及自身免疫有关。肌无力、肌痛是普遍存在的症状。肌酸激酶常中度升高。一般肌电图和肌活检无特异性改变。【结论】甲状腺功能减退性肌病好发于男性,该病患者具有甲状腺功能减退的症状群和肌病的症状群。甲状腺激素替代是主要治疗手段。该病预后尚好。

[Objective]To increase our knowledge of hypothyroidism myopathy and improve its diagnosis and treatment. [Methods]A case of hypothyroidism myopathy combined with diabetes mellitus was reported. CJFD cases reported in the Chinese literatures from January, 2000 till 2006 and foreign literatures by PUBMED were reviewed, [Results]This case was a middle-aged male with diabetes. The symptoms and signs were significantly improved after thyroid hormone replacement for two weeks. Altogether 16 internal cases and many foreign cases, most of whom were male, were found. Its mechanism might be related with heredity ,immunity and metabolism. CK was moderately elevated. Usually no specific signs could be found on muscle biopsy. Muscle weakness and myalgia were common symptoms. The electromyography and muscle biopsy were usually not specific. [Conclusion]The incidence of hypothyroidism myopathy of male is higher than that of females. The clinical manifestations include symptoms of both hypothyroidism and myopathy. Thyroid hormone replacement therapy is the main treatment. Its prognosis is usually good.