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糖皮质激素对甲状腺功能减退所致Ⅱ型呼吸衰竭、心力衰竭及大量心包积液的治疗作用:一例报告。

The therapeutic effect of glucocorticoids on type II respiratory failure, heart failure, and massive pericardial effusion caused by hypothyroidism: A case report.

作者信息

Wang Jingyue, Li Xiangjun, Shen Botao, Wang Shipeng, He Jiahuan, Wang Yushi

机构信息

Department of Cardiology, The First Hospital of Jilin University, Changchun, China.

出版信息

Front Pharmacol. 2022 Oct 17;13:900701. doi: 10.3389/fphar.2022.900701. eCollection 2022.

Abstract

Hypothyroidism is a disease commonly observed in outpatient clinics but can occasionally cause severe cardiovascular and respiratory diseases requiring hospitalization. The patient reported herein suffered from heart failure, massive pericardial effusion, type II respiratory failure, and hypothyroidism. There was no related basic diseases of respiratory and cardiovascular system in the past. She failed to be weaned from invasive ventilation multiple times after routine treatment and was finally successfully weaned on day five of receiving the combination therapy of a high-dose methylprednisolone intravenous drip and levothyroxine oral administration. This case report indicates that hypothyroidism may be a cause of type II respiratory failure, heart failure, and massive pericardial effusion without cardiac tamponade and that a combination of levothyroxine and corticosteroids could effectively treat the disease. Clinical workers should consider the role of thyroid function in diagnosis, and the admission team should include this aspect in the monitoring scope. Moreover, the role of hormones in the treatment of patients with severe hypothyroidism should not be ignored, and timely treatment should be provided.

摘要

甲状腺功能减退症是门诊常见疾病,但偶尔可导致严重的心血管和呼吸系统疾病而需住院治疗。本文报告的患者患有心力衰竭、大量心包积液、II型呼吸衰竭和甲状腺功能减退症。既往无呼吸和心血管系统相关基础疾病。常规治疗后多次尝试脱机均失败,最终在接受大剂量甲泼尼龙静脉滴注联合左甲状腺素口服治疗的第5天成功脱机。本病例报告表明,甲状腺功能减退症可能是II型呼吸衰竭、心力衰竭和大量心包积液而无心脏压塞的病因,左甲状腺素和皮质类固醇联合使用可有效治疗该病。临床工作者应考虑甲状腺功能在诊断中的作用,收治团队应将这方面纳入监测范围。此外,激素在重度甲状腺功能减退症患者治疗中的作用不应被忽视,应及时给予治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37bd/9618854/d2950401c409/fphar-13-900701-g001.jpg

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