摘要
目的探讨亚临床甲状腺功能减退症(SCH)的误诊原因,提高对本病的认识。方法回顾性分析2021年9月—2023年9月SCH误诊4例的临床资料。结果4例中1例因反复紧张不安、心烦、腹胀、食欲差半年,加重伴消瘦1个月就诊,误诊为植物神经功能紊乱、慢性胃炎;1例因情绪不稳、烦躁、记忆力减退、自我评价下降、睡眠差2年就诊,误诊为焦虑抑郁状态;1例因持续紧张害怕、胸闷心烦、头昏、食欲减退半年,加重伴疲乏感半个月就诊,曾诊断为围绝经期综合征;1例因心烦、胸闷、情绪低落、体力下降、睡眠差1年,加重2周就诊,误诊为贫血、高脂血症。误诊时间0.5~2年。予相应处理效果不佳,经查甲状腺功能确诊为SCH。4例确诊后给予左甲状腺素等针对性治疗2个月~半年,均效果良好,达到临床治愈。结论SCH是临床常见的内分泌疾病,是甲状腺功能减退症的早期阶段,发病率高,起病隐匿,临床症状表现各异且不典型,容易漏诊和误诊。临床医生应提高对该病认识,及时行相关检查和专科会诊,可减少或避免误诊误治。
Objective To explore the causes of misdiagnosis of subclinical hypothyroidism(SCH)and to improve understanding of this disease.Methods The clinical data of 4 cases with SCH misdiagnosed from September 2021 to September 2023 were retrospectively analyzed.Results Among the 4 cases,1 case was misdiagnosed as autonomic nervous disorder and chronic gastritis due to repeated nervousness,upset,abdominal distension,poor appetite for half a year,which were aggravated with weight loss for 1 month.One patient was misdiagnosed with anxiety and depression due to emotional instability,irritability,memory loss,decreased self-evaluation,and poor sleep for 2 years.One case was misdiagnosed as climacterium syndrome due to persistent nervousness,chest distress,dizziness,loss of appetite for six months,which were aggravated with fatigue for half a month.One patient was misdiagnosed as anemia and hyperlipidemia due to upset,chest tightness,low mood,decreased physical strength and poor sleep for 1 year,which were aggravated for 2 weeks.The misdiagnosis lasted six months to two years.Patients did not respond well to the corresponding treatment,and upon the diagnostic test of thyroid function,it was confirmed as SCH.After diagnosis,4 cases were given targeted treatment such as Levothyroxine for 2 months to 6 months,all of which had good effect and achieved clinical cure.Conclusion SCH is a common endocrine disease in clinic practice,which is the early stage of hypothyroidism,with high incidence rate,hidden onset,various and atypical clinical symptoms,and likelihood to miss diagnosis and misdiagnosis.Clinicians should improve their understanding of the disease,and timely relevant examinations and specialist consultation may help reduce or avoid misdiagnosis and mistreatment.
作者
高明秀
付华斌
李秀景
祁革
赵会懂
GAO Mingxiu;FU Huabin;LI Xiujing;QI Ge;ZHAO Huidong(Department of Psychiatry,the 980th Hospital of Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China;Department of Medical Information Data,the 980th Hospital of Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China)
出处
《临床误诊误治》
CAS
2024年第2期29-34,共6页
Clinical Misdiagnosis & Mistherapy
