甲状腺激素抵抗综合征合并Graves病一例临床分析

Resistance to thyroid hormone complicated with Graves＇ disease： One case report

分析甲状腺激素抵抗综合征合并Graves病甲状腺功能亢进症的临床特征及诊疗方法。对本院收治的1例甲状腺激素抵抗综合征合并Graves病患者进行讨论分析，并复习相关文献，总结该病的临床特征及诊疗方法。甲状腺激素抵抗综合征以甲状腺激素水平升高，但促甲状腺素水平正常或偏高为主要表现，往往合并β受体突变。甲状腺激素抵抗综合征合并Graves病时，甲状腺功能亢进和抵抗的表现均有，经治疗后甲状腺功能难以恢复正常。治疗上首选药物治疗，不建议放射性碘和手术治疗，控制目标需结合患者的临床表现及甲状腺功能水平。

To raise the awareness of resistance to thyroid hormone complicated with Graves＇ disease by analyzing the clinical features and management of a patient with resistance to thyroid hormone complicated with Graves＇ disease. One case of resistance to thyroid hormone complicated with Graves＇ disease in our hospital was retrospectively analyzed, including clinical feature, laboratory findings, treatment, and follow-up. All the data and pertinent literatures were reviewed and analyzed. Free thyroxine （ FT4 ） and free triiodothyronine （ FT3 ） levels are elevated and thyroid stimulating hormone （TSH） level is normal or mildly elevated, accompanied by thyroid enlargement. Thyroid receptor β gene mutation exists in most thyroid hormone resistance syndrome but does not exist in a few others, its molecular etiology is unclear. The disease of resistance to thyroid hormone complicated with Graves＇ disease has the symptoms of both disorders, nolnal thyroid function is hardly achieved by t,＇eatment. Oral medicine therapy is the first choice while radioactive iodine and surgery are not recommended, and the objectives should be set according to clinical manifestations and thyroid function individually.