Hehrmann R
Medizinische Klinik I, Diakonissenkrankenhaus Stuttgart.
Fortschr Med. 1996 Dec 10;114(34):474-8.
Myxedema coma is the most severe form of hypothyroidism and is characterized by extreme hypothermia, bradycardia, central hypoventilation and hypoxia. Common causes are intercurrent diseases, interruption of thyroid hormone treatment, or an overdose of sleeping pills or sedatives. The diagnosis is usually readily established on the basis of very high serum TSH and low T4 levels. Consideration must also be given to an extra-thyroidal influence on the hormone levels. Intensive care treatment involving intravenous high-dose L-thyroxine and the reversal of hypoxia improve the prognosis of the serious disease.
黏液水肿性昏迷是甲状腺功能减退最严重的形式，其特征为体温极低、心动过缓、中枢性通气不足和缺氧。常见病因包括并发疾病、甲状腺激素治疗中断、或安眠药或镇静剂过量。通常根据血清促甲状腺激素水平极高和T4水平低来确诊。还必须考虑甲状腺外因素对激素水平的影响。采用静脉注射大剂量左甲状腺素的重症监护治疗以及纠正缺氧可改善这种严重疾病的预后。
