表现不典型的老年甲状腺功能亢进误诊37例分析

Misdiagnosis Analysis of 37 Cases of Atypical Senile Hyperthyroidism

目的探讨表现不典型的老年甲状腺功能亢进的误诊原因。方法回顾分析广西医科大学一附院近6年来初诊时被误诊的表现不典型的老年甲状腺功能亢进患者37例的临床资料。结果被误诊为慢性结肠炎7例,恶性肿瘤5例,风湿性心脏病4例,高血压性心脏病、冠心病、病毒性心肌炎、神经官能症、周期性麻痹各3例,病毒性肝炎、肺结核、糖尿病各2例。结论老年甲状腺功能亢进临床表现不典型,慢性腹泻、厌食、消瘦、心律失常、神经兴奋性亢进等可为其首发临床表现,应考虑到甲状腺功能亢进,并进行甲状腺功能检测,才能避免误诊。

Objective To discuss the misdiagnosed reasons of atypical senile hyperthyroidism.Methods To analyze retrospectively the clinical data of 37 cases of misdiagnosed atypical senile hyperthyroidism in our hospital for recent 6 years.Results There are 7 cases were misdiagnosed as chronic colitis,5 cases were misdiagnosed as malignant tumor,4 cases were misdiagnosed as rheumatic heart disease,and there are 3 cases were misdiagnosed respectively as hypertensive heart disease,coronary heart disease,viral myocarditis,neurosis and periodic paralysis,2 cases were misdiagnosed respectively as viral hepatitis,tuberculosis and diabetes mellitus.Conclusion The clinical manifestations of senile hyperthyroidism are not so typical.Chronic diarrhea,anorexia,weight loss or arrhythmia may be the initiative clinical manifestations.In order to avoid misdiagnosis,hyperthyroidism should be taken into account,and thyroid function tests should be taken.