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甲状腺功能减退的神经学表现:29只犬的回顾性研究

Neurological manifestations of hypothyroidism: a retrospective study of 29 dogs.

作者信息

Jaggy A, Oliver J E, Ferguson D C, Mahaffey E A, Glaus T

机构信息

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens.

出版信息

J Vet Intern Med. 1994 Sep-Oct;8(5):328-36. doi: 10.1111/j.1939-1676.1994.tb03245.x.

Abstract

Neuromuscular signs in association with hypothyroidism are described in 29 dogs. Eleven dogs had lower motor neuron signs, 9 had peripheral vestibular deficits, 4 had megaesophagus, and 5 had laryngeal paralysis. Primarily older (mean = 9.5 years), large-breed dogs were affected, and there was no sex or breed predisposition. Duration of clinical signs before presentation ranged from 2 to 8 weeks (mean = 5 weeks). The diagnosis was based on (1) results of neurological examination (29 dogs); (2) electromyographic abnormalities (18 dogs), including fibrillation potentials (n = 18), positive sharp waves (n = 15), and complex repetitive discharges (n = 4); (3) high serum cholesterol concentration (10 dogs; mean = 335 mg/dL); (4) low response to thyroid-stimulating hormone (29 dogs; mean T4 prestimulation concentration = 0.8 micrograms/dL; mean T4 poststimulation = 1.2 microgram/dL); and (5) good response to thyroxine supplementation (26 dogs). Dogs with vestibular deficits had abnormal brainstem auditory-evoked responses (BAER), including increased latencies of P1-P6 and decreased amplitude of P4,5-N5. Seven other dogs had similar BAER abnormalities without manifesting clinical signs of vestibular involvement. Three dogs with vestibular signs had fibrillation potentials and positive sharp waves without exhibiting lower motor neuron signs. All dogs were supplemented with levothyroxine (0.02 mg/kg PO bid). The follow-up period ranged between 6 and 30 months (mean, 14 months). Serum T4 concentrations were measured at least 3 times for each dog every 2 months (mean T4 concentration = 2.6 micrograms/dL). All but 1 dog with lower motor neuron signs and 1 dog with vestibular signs recovered after 2 months (mean, 57 days).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

29只犬出现了与甲状腺功能减退相关的神经肌肉体征。11只犬有下运动神经元体征,9只犬有外周前庭功能障碍,4只犬有巨食管症,5只犬有喉麻痹。主要是年龄较大(平均9.5岁)的大型犬受到影响,且无性别或品种易感性。就诊前临床体征持续时间为2至8周(平均5周)。诊断依据为:(1)神经学检查结果(29只犬);(2)肌电图异常(18只犬),包括纤颤电位(n = 18)、正锐波(n = 15)和复合重复放电(n = 4);(3)高血清胆固醇浓度(10只犬;平均 = 335 mg/dL);(4)对促甲状腺激素反应低下(29只犬;刺激前平均T4浓度 = 0.8微克/dL;刺激后平均T4 = 1.2微克/dL);(5)补充甲状腺素后反应良好(26只犬)。有前庭功能障碍的犬脑干听觉诱发电位(BAER)异常,包括P1 - P6潜伏期延长和P4,5 - N5波幅降低。另外7只犬有类似的BAER异常,但无前庭受累的临床体征。3只有前庭体征的犬有纤颤电位和正锐波,但无下运动神经元体征。所有犬均补充左甲状腺素(0.02 mg/kg口服,每日两次)。随访期为6至30个月(平均14个月)。每只犬每2个月至少测量3次血清T4浓度(平均T4浓度 = 2.6微克/dL)。除1只有下运动神经元体征的犬和1只有前庭体征的犬外,所有犬在2个月(平均57天)后恢复。(摘要截选至250字)

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