Sutor G C, Klocke M, Hamm M, Fabel H, Schuppert F
Abteilung Pneumologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover.
Dtsch Med Wochenschr. 2001 Feb 9;126(6):134-7. doi: 10.1055/s-2001-11043.
A 44-year-old manager presented himself for the assessment of nocturnal apnoea. He reported increasing lack of drive and nightly angina pectoris.
Polysomnography indicated obstructive apnoea and hypopnoea with a respiratory disturbance index of 29.1, while the ECG showed T wave inversion in all leads. There was severe hypothyroidism with atrophic thyroid tissue.
DIAGNOSIS, TREATMENT AND COURSE: The patient had an obstructive sleep apnoea syndrome (OSAS), hypothyroidism with myxoedema, hypopnoea and myocardial ischaemia. He was treated with negative peak airway pressure (nCPAP) ventilation, administration of L-thyroxine and initiation of anti-anginal medication, which relieved his symptoms. The severe hypothyroidism was thought to be the most important cause of his respiratory disorder and angina.
This case illustrates the connection between hypothyroidism and OSAS. Hypothyroidism must be excluded in patients with OSAS, regardless of the patient's age.
一名44岁的经理因夜间呼吸暂停前来接受评估。他自述精力日益缺乏且每晚发作心绞痛。
多导睡眠监测显示为阻塞性呼吸暂停和呼吸不足，呼吸紊乱指数为29.1，而心电图显示所有导联T波倒置。存在伴有甲状腺组织萎缩的严重甲状腺功能减退。
诊断、治疗与病程：该患者患有阻塞性睡眠呼吸暂停综合征（OSAS）、黏液性水肿型甲状腺功能减退、呼吸不足和心肌缺血。对其进行了气道负压峰值（nCPAP）通气治疗、左甲状腺素给药并开始使用抗心绞痛药物，这些措施缓解了他的症状。严重甲状腺功能减退被认为是其呼吸障碍和心绞痛的最重要原因。
该病例说明了甲状腺功能减退与OSAS之间的联系。对于OSAS患者，无论其年龄大小，均须排除甲状腺功能减退。
