【摘要】 <正> 原发性甲状腺功能减退症（下称甲低）占各种原因引起的甲低绝大多数,起病隐袭或以少见并发症为首发症状及主要表现时,诊断较为困难。本文分析46例资料,总结甲低的少见并发症特点,着重阐述 TT₄,TT₃,TSH 测定,TRH 兴奋试验的诊断意义。更多还原

【Abstract】 The clinical manifestations of 46 cases of primary hypothyroidism were analysedand comment on the diagnosis of atypical cases was made.Among the 46 patients,thereare eight males and thirty-eight females.The male to female retio is 1:4.8.The ageof the patients ranged from 27 years to 73 years（average 48.6 years）.The durationof illness varied from 1 month to 36 years（average 8.1 years）.Primary hypothyroi-dism should be suspected in patients with edema of unknown origin,cardiac enlarge-ment with pericardial effusion,polyserositis,hypocalcemia,galactorrhea,amenorrhea,and myasthenia,especially in female patients of more than 40 years of age.The lo-wering of serum TT₃ and TT₄ were pathognomonic for the diagnosis of primary hypo-thyroidism but the so-called euthyroid sick syndrome should be ruled out.Since thelowering of seum TT₄ occurred more frequently than the lowering of serum TT₃,theformer is diagnostically more significant.There were 4 patients with normal TT₄ andTT₃.The determination of TSH and the TRH stimulating test were helpful in the dia-gnosis of these patients.Five atypical cases implicating in diagnosis were also breiflydiscussed.更多还原