老年人甲状腺功能亢进症的临床分析

Clinicalanalysisofhyperthyroidismintheelderly

目的分析老年人甲状腺功能亢进症（老年甲亢）的临床特点。方法对2008年1月～2008年10月期间上海市华山医院及华东医院内分泌科门诊就诊的49例年龄≥60岁的老年甲亢患者与随机抽取的上述医院同期内分泌科门诊就诊的55例年龄〈60岁的甲亢患者的临床资料进行回顾性分析。结果老年甲亢患者临床症状常以心血管系统、消化道系统和／或神经精神系统症状为主；淡漠、嗜睡仅见于老年组；老年甲亢患者甲状腺肿大程度较轻，甲状腺结节多见，突眼者少见；糖代谢异常及贫血在老年组多见。两组患者血清FT4、TSH值比较差异无统计学意义，但老年组血清FT3值明显低于非老年组。结论老年甲亢的临床特点（1）甲亢临床症状和体征多不典型（2）易伴随贫血、糖代谢异常等疾病；（3）甲状腺功能检查提示FT3值的升高不如非老年组患者明显。

Objective To analyze the clinical features of hyperthyroidism in elderly patients. Methods Clinical data of 49 elderly patients and 55 young patients diagnosed with hyperthyroidism and treated in the departments of endocrinology of Huadong and Huanshan hospitals （both Level 3 hospitals） between January and October 2008 were retrospectively analyzed. Results The symptoms of the digestive system, cardiovascular system and nervous system were most common in elderly patients. Apathy and lethargy were mostly found in the elderly patients and rarely in the young patients. Mild forms of thyroid goiters and nodules were common while exophthalmos were rare signs in the elderly. Disturbance of carbohydrate metabolism and anemia were often seen in the elderly. Serum FT3 was significantly lower in the elderly compared to that in the young, but there was no significant difference in FT, and TSH between the two groups of patients. Conclusions Features of hyperthyroidism in the elderly included （1） symptoms and signs of hyperthyroidism were atypical; （2） anemia and disturbance of carbohydrate metabolism were frequent presentations; （3） increase of serum FT3 was less significant as compared with that in the young patients.