甲状腺功能亢进症19例误诊分析

Misdiagnosis Analysis of 19 Cases of Hyperthyroidism

目的:提高对临床症状不典型甲状腺功能亢进症的认识,减少误诊率。方法:回顾性总结、分析误诊的19例甲状腺功能亢进症临床资料。结果:19例误诊为植物神经功能紊乱。所有病例均经甲状腺功能(T3、T4、TSH)等检查确诊为甲状腺功能亢进症,并经抗甲状腺素药物治疗或放射性碘131治疗后病情好转。结论:甲状腺功能亢进症并发植物神经功能紊乱是一组人体器官功能失调的症候群。常表现为神经系统、循环系统、消化系统、泌尿生殖系统功能失调症状,这些症状往往集中在某一脏器或器官,组织结构上并无相应病理变化,因而常依据出现症状的器官而被诊断为心脏神经症、胃肠神经症、神经性尿频等。临床应及时进行T3、T4等检查,以便早期诊断,减少误诊率。

Objective： to promote the understanding of a typical hyperthyroidism, and reduce misdiagnosis rate. Methods： summarize and analyze the clinical data of 19 cases of misdiagnosed hyperthyroidism retrospectively. Results： all the 19 cases of hyperthyroidism were misdiagnosed as vegetative nerve dysfunction, and with the test of thyroid funetion（T3,%,TSH） confirmed diagnosis Of hyperthyroidism was established, and after treating with anti-thyroid drugs of radioactive 1131, all 19 patients got better. Conclusion： Hyperthyroidism with dysfunction of vegetative nerve is a series of symptoms of organ dysfunetion, which usually involves organs in nerve, circulation, digestive and genitourinary system. And not uncommonly, only one organ was involved without pathological changes in the organ structure. As a result, hyperthyroidism was misdiagnosed as heart neurosis, gastrointestinal neurosis and neuropathie polyuria. Tests such as T3,T4 ete should be carried out in time to make the diagnosis earlier and reduce misdiagnosis rate.