老年原发性甲状腺功能减退症的临床误诊分析

目的探讨老年原发性甲状腺功能减退症（甲减）的临床特点及误诊原因，以提高临床诊断水平。方法回顾性分析40例老年甲减患者误诊的临床资料。结果老年性甲减起病隐袭，临床表现多样复杂。误诊为冠心病10例，脂肪肝7例，慢性胃炎5例，胸腔积液5例，心包积液4例，慢性心功能不全3例，高血压病2例、贫血2例和老年痴呆症2例。经甲状腺功能检查确诊为甲减，予甲状腺片治疗后病情恢复良好。结论老年人缺乏典型症状，临床表现多样。极易造成误诊、误治．提高对老年甲减的认识，综合分析病情，是明确诊断、减少误诊的关键。

Objective To explore the clinical features and misdiagnosis of primary primary hypothyroidism in old patients to improve the level of clinical diagnosis. Methods The misdiagnosed clinical data of 40 cases of elderly patients with hypothyroidism was retrospective analyzed. Results The onset of senile hypothyroidism was insidious, and clinical manifestations was complex. 10 cases were misdiagnosed as coronary heart disease, 7 cases of fatty liver, chronic gastritis 5 cases, 5 cases of pleura1 effusion, 4 cases of pericardial effusion, 3 cases of chronic cardiac insufficiency, 2 cases of hypertension, 2 cases of anemia and 2 cases of senile dementia. The thyroid function tests diagnosed with hypothyroidism, the disease to recover well treated with thyroid tablets. Conclusion The typical symptoms of primary primary hypothyroidism is lack, and clinical manifestations are complex.It is easy to be misdiagnosed, and mistreatment. The improvement on awareness of senile hypothyroidism, comprehensive analysis of disease severity, is the key for definitive diagnosis, decrease misdiagnosis.