《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (01): 19-21.

• 专题 • 上一篇    下一篇

成人甲状腺功能减退性肌病的临床表现

王锁彬;贾建平   

  1. 首都医科大学宣武医院神经内科,北京市 100053
  • 收稿日期:2008-10-20 出版日期:2009-01-01 发布日期:2009-01-01

Hypothyroid Myopathy in Adults: 19 Cases Report

WANG Suo-bin, JIA Jian-ping   

  1. Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
  • Received:2008-10-20 Published:2009-01-01 Online:2009-01-01

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被引次数

21

摘要： 目的 了解成人甲状腺功能减退性肌病（HTM）的特点。方法 对19例成人HTM的临床资料和实验室检查进行分析。结果 成人HTM可表现为肢体近端肌无力、肌肉酸痛、肌痉挛、肌强直样改变、活动后肌僵硬，也可伴发全身多处肌肉肥大，咀嚼时出现颞肌肿胀。给予甲状腺素替代治疗可获得满意效果。甲状腺功能减退还可引起重症肌无力。需与多发性肌炎相鉴别。结论 对有肌病表现，肌酶升高的患者，应检查甲状腺功能，避免误诊为多发性肌炎或其他疾病。

关键词: 甲状腺功能减退性肌病, 多发性肌炎, 肌肥大, 重症肌无力, 诊断

Abstract: Objective To study the characteristics of hypothyroid myopathy in adults. Methods The clinical, biochemical, electromyographic, and pathologic characteristics of 19 patients with hypothyroid myopathy were analysed retrospectively. Results Proximal muscle weakness and elevation of muscle enzymes were the most common features. Other common clinical manifestations were myalgia, cramps, pseudomyotonia or stiffness after exercise. Muscular weakness with pseudohypertrophy was presented in some patients. Myoedema of temporal muscle was elicited by chewing continually. Hypothyroidism may be related to the pathogenesis of myasthenia gravis. Patients treated with levothyroxine achieved satisfactory outcomes. Hypothyroid myopathy is different from polymyositis in many aspects. Conclusion All patients presenting muscular weakness or elevation of muscle enzymes should be studied with their function of thyroid in order to avoid misdiagnosis.

Key words: hypothyroid myopathy, polymyositis, muscular hypertrophy, myasthenia gravis, diagnosis