Yamamoto K, Saito K, Takai T, Yoshida S
Prog Clin Biol Res. 1983;116:169-87.
Nineteen patients with overt hypothyroidism were examined for the prevalence of myocardial disfunction, respiratory disturbances, peripheral neuropathy, and visual failure due to pituitary enlargement. Prevalences of pericardial effusion and myocardial disfunction (decrease PEP/LVET) were 50% and 75%, respectively. The degree of decreased myocardial function did not parallel with the grade of pericardial effusion. Arterial blood analysis indicated a frequent incidence of hypoxia in hypothyroidism. The incidence of hypoxia was 69%. The hypoxia was improved by thyroxine replacement therapy. In 6 patients examined for the ventilatory control, all had the index for hypercapnic ventilatory drive lower than normal control. It was suggested that the hypoxia in hypothyroidism was caused by a depression of the respiratory center in the brain and by anemia. Sensory nerve conduction was diminished in 6 of 11 hypothyroid patients and motor conduction in 6 of 15 was studied. In distal segments of sensory nerves, the abnormality frequently appeared before clinical symptoms of polyneuropathy. Visual field defect was detected in 71% of patients suffering of primary hypothyroidism. The most common characteristic change was the defect in the central visual field. All cases of visual field defect were cured by thyroid hormone replacement therapy. Two cases with deteriorated visual failure who did not improve during physiological replacement, were successively treated with over dosage of thyroid hormone.
对19例显性甲状腺功能减退患者进行了检查，以确定因垂体肿大导致的心肌功能障碍、呼吸紊乱、周围神经病变和视力减退的患病率。心包积液和心肌功能障碍（PEP/LVET降低）的患病率分别为50%和75%。心肌功能降低的程度与心包积液的分级不平行。动脉血气分析表明，甲状腺功能减退患者中缺氧发生率较高。缺氧发生率为69%。甲状腺素替代治疗可改善缺氧情况。在6例接受通气控制检查的患者中，所有患者的高碳酸血症通气驱动指数均低于正常对照组。提示甲状腺功能减退患者的缺氧是由脑呼吸中枢抑制和贫血引起的。11例甲状腺功能减退患者中有6例感觉神经传导减弱，对15例中的6例进行了运动传导研究。在感觉神经的远端节段，异常常在多发性神经病变的临床症状出现之前出现。在原发性甲状腺功能减退患者中，71%检测到视野缺损。最常见的特征性改变是中心视野缺损。所有视野缺损病例均通过甲状腺激素替代治疗治愈。2例视力减退恶化且在生理性替代治疗期间未改善的患者，先后接受了过量甲状腺激素治疗。
