Barton E N, Kelly D, Morrison E Y
Department of Medicine, U.W.I., Jamaica.
West Indian Med J. 1991 Mar;40(1):26-8.
A retrospective study of 58 hypothyroid patients attending the Endocrine Clinic, University Hospital of the West Indies, Jamaica, between July and August 1989, was undertaken. The age range at initial presentation varied from one month to eighty-four years. The majority of cases (51 or 87.9%) were between 21 and 70 years. There were 50 females (86.2%) and 8 males (13.8%). The underlying causes were idiopathic hypothyroidism (35 or 60.3%), posthyroidectomy (13 or 22.4%), post I131 therapy (6 or 10.4%), panhypopituitarism (3 or 5.2%), hypophysectomy (1 or 1.7%). Biochemical parameters used in diagnosis were serum thyroxine (T4) and thyroid-stimulating hormone (TSH). Forty-six patients (79.2%) had elevated TSH, indicative of a high correlation of elevated TSH with hypothyroidism. Duration of symptomatology prior to diagnosis was one year in 27 patients (46.5%), 2-10 years in 23 (39.6%) and 10 years in 4 cases (6.9%). The major presenting signs and symptoms were lethargy (20 or 34.5%), anaemia (mixed normochromic, microcytic (16 or 27.6%), slow relaxation of tendon reflexes (16 or 27.6%), coarsening of skin (15 or 25.9%), weight gain 10 or 17.2%), hoarseness (9 or 15.5%) and psychiatric symptoms (7 or 12%). The known association of primary hypothyroidism with other autoimmune disorders was not borne out in this study. The time-lapse in diagnosis from symptomatology emphasized the need for clinicians to be more alert to the subtle and varied presentation of hypothyroidism.
对1989年7月至8月期间在牙买加西印度群岛大学医院内分泌科就诊的58例甲状腺功能减退患者进行了一项回顾性研究。初次就诊时的年龄范围从1个月到84岁不等。大多数病例（51例，占87.9%）年龄在21岁至70岁之间。其中有50名女性（86.2%）和8名男性（13.8%）。潜在病因包括特发性甲状腺功能减退（35例，占60.3%）、甲状腺切除术后（13例，占22.4%）、I131治疗后（6例，占10.4%）、全垂体功能减退（3例，占5.2%）、垂体切除术（1例，占1.7%）。用于诊断的生化指标是血清甲状腺素（T4）和促甲状腺激素（TSH）。46例患者（79.2%）TSH升高，表明TSH升高与甲状腺功能减退高度相关。诊断前症状持续时间为1年的有27例患者（46.5%），2至10年的有23例（39.6%），10年的有4例（6.9%）。主要的体征和症状包括嗜睡（20例，占34.5%）、贫血（正细胞正色素性与小细胞性混合，16例，占27.6%）、腱反射松弛缓慢（16例，占27.6%）、皮肤粗糙（15例，占25.9%）、体重增加（10例，占17.2%）、声音嘶哑（9例，占15.5%）和精神症状（7例，占12%）。本研究未证实原发性甲状腺功能减退与其他自身免疫性疾病之间已知的关联。从症状出现到诊断的时间间隔强调了临床医生需要对甲状腺功能减退的细微和多样表现更加警惕。
