原发性甲状腺功能减退症的误诊分析

Misdiagnosis of Primary Hypothyroidism

目的:分析原发性甲状腺功能减退症的常见误诊原因,提高对不典型原发性甲状腺功能减退症的诊断水平,减少其误诊、漏诊率。方法:回顾性分析某院内分泌科2014年1月~2014年12月期间收治的29例被误诊为其他疾病的原发性甲状腺功能减退症患者作为研究样本,对所有患者的临床表现、实验室检查结果以及误诊情况进行总结分析。结果:(1)本组29例误诊患者中,临床表现以胸闷、气短、恶心、呕吐为主;(2)29例误诊患者的原发疾病主要以心脏疾病、胃肠疾病、慢性肾炎为主;(3)治疗后,甲减患者的BGP、FT3、FT4水平均明显高于治疗前,均具有统计学意义,P<0.05。结论:原发性甲状腺功能减退症的临床症状复杂,缺乏特异性,在诊断中要注意加强对乏力、贫血以及浮肿等症状的患者的鉴别,必要时选择甲状腺功能检查以提高诊断准确性。

Objective:To analyze the causes of misdiagnosis of primary hypothyroidism,and to improve the diagnostic level of atypical primary hypothyroidism and reduce misdiagnosis and missed diagnosis.Methods:A retrospective analysis of 29 cases of misdiagnosed primary hypothyroidism patients in a hospital from January 2014 to December 2014 was conducted.The clinical manifestations,laboratory examination results and the misdiagnosis of all patients were analyzed.Results:(1)The clinical manifestations of 29 cases of misdiagnosis were chest distress,shortness of breath,nausea and vomiting;(2)The primary diseases of 29 cases of misdiagnosed patients were mainly heart disease,gastrointestinal disease and chronic nephritis;(3)After treatment,the BGP,FT3,FT4 levels of patients with hypothyroidism were significantly higher than those before treatment,which the difference was statistically significant(P<0.05).Conclusion:The clinical symptoms of primary hypothyroidism are complex and lack specificity.Attention should be paid to the differential diagnosis of patients with symptoms such as fatigue,anemia and edema,and thyroid function tests are selected if necessary,so as to improve the accuracy of diagnosis.