89例老年住院病人甲状腺异常分析

Analysis of thyroid dysfunction in 89 cases of elderly inpatients

目的 探讨因各种急性或慢性疾病就诊的老年病人的甲状腺形态、功能状况。方法 89例因非甲状腺疾病就诊的住院病人 ,均于入院当日晨起时抽空腹静脉血检测T3 、T4、FT3 、FT4、TSH、rT3 。其中 3 9例行甲状腺B超检查。结果 筛查出临床甲状腺功能减退症 (甲减 )患者 4人 (4 49% ) ,亚临床甲减 5人 (5 61% ) ,另有TSH >4 0mU/L 9人(13 75 % ) ,其中TSH >5 0mU/L 3人 (3 92 % )。 3 3人有T3 /FT3 不同程度降低 ,其中甲状腺功能正常性病变综合征 (SES ,低T3 /低T4综合征 ) 11例 (12 3 % ) ,低T3 、T4综合征 4例。结论 在老年住院病人中 ,甲状腺功能减退是一种发病率高又极其容易被漏诊的疾病 ,同时SES ,T3 /FT3 的降低程度及FT3 的升高程度与疾病的严重程度及预后有关系。

Objective To determine the prevalence of thyroid dysfunction in elderly inpatients in our geriatric ward and evaluate the relationship between such dysfunction and other underlying diseases Methods Thyroid function tests(free and total thyroxine,T 4/triiodothyronine,T 3;thyroid stimulating hormone,TSH;reverse T 3,rT 3) were performed on all patients during routine blood screening Some of them were screened by B ultrasound test Results A total of 89 patients were screened and 42(47 2%) patients were found to have abnormal thyroid dysfunction,58 9%(23/39)of patients had nodular goiter The prevalences of thyroid disorders were as follows:4(4 49%) patients had overt hypothyroidism,5(5 61%)patients had subclinical hypothyroidism and 11(12 3%) patients had sick euthyroid syndrome Conclusion There was a high prevalence of thyroid dysfunction in the elderly in patients We should advocate a lower threshold for screening elderly inpatients for throid dysfunction