老年人甲状腺功能亢进危象特征与诊断3例分析

Diagnosis of the Hyperthyroidism Crisis in the Elderly──Analysis of Three Cases

目的：探讨老年人甲状腺功能亢进（甲亢）危象的临床特点、诊断，以引起人们对老年人不典型甲亢危象的认识．方法：本文3例经甲状腺功能测定确诊的老年甲亢病人，据临床表现诊断为甲亢危象，按危象抢救后症状缓解．结果：随着人们对疾病早期防治意识的提高，成人典型甲亢危象已非常罕见．不可忽视的是，临床上对老年人不典型甲亢认识不足，以至漏诊、误治诱发危象．而老年人甲亢危象表现不具典型，使诊治一误再误，最终可能将甲亢危象死亡误为是其它疾病不治．本文3例均为甲亢误诊诱发危象，由于积极抢救，均痊愈．结论：典型甲亢危象日渐罕见，而老年人甲亢危象仍不可忽视，其临床表现不具典型，应给予警觉．

Objective: To observe the clinical appearance and diagnosis of hyperthyroidism crisis in theelderly. and to call people's attention to the untypical hyperthyroidism crisis in the elderly. Methods:Three cases who were confirmed diagnosis by performing thyroid function measure were diagnosedhyperthyroidism crisis according to their clinical appearence. After curing the hyperthyroidism crisis, thesymptoms were relieved and then followed for six months. Result: The typical adults'hyperthyroidismcrisis is very rare. What could not be ignored is that there is not enough attention to the elderuntypical hyperthyroidism in clinical medicine which leads to missed and erroneous diagnosis and induceshyperthyroidism crisis. While the appearance of the aged huperthyroidism crisis is always untypicaland leads to one after another erroneous diagnosis and even the death of byperthyrooidism crisis whichcould be mistaken for the death of other disesses in the end. Three oues here were all hyperthyroidimbut erroneous diagnosed which evoked hyperthyroidism crisis. Because of active emergency treatment,they were all recovered. Conclusion: Up till now, the typical adult hyperthyrodism crises is graduallyrare. However, the aged hyperthyroidism crisis should not' be ignored. Its clinical appearance is not typi-cal and should be on the alert.