难治性甲状腺功能减退合并甲状腺相关眼病及甲状腺肢端肥大病因分析及研究进展

Etiologocal Analysis and Research Progress of Refractory Hypothyroidism with Thyroid Eye Disease and Thyroid Acropachy

摘要: 目的：探讨难治性甲状腺功能减退的病因、并发症、治疗和预后。方法：对难治性甲状腺功能减退合并甲状腺相关眼病及甲状腺肢端肥大患者进行病因分析并总结研究进展。结果：不规律应用左甲状腺素治疗甲状腺功能减退后出现难治性甲状腺功能减退，并发甲状腺相关眼病及甲状腺肢端肥大，调节左甲状腺素用量及糖皮质激素冲击治疗可缓解其症状。结论：难治性甲状腺功能减退合并甲状腺相关眼病、甲状腺肢端肥大的病例是极少见的，原因与患者依从性差、吸烟和甲状腺自身抗体阳性等密切相关。此外，可能还有其他没有观察到的原因。当面对这类病人时，应该关注其风险因素及调整治疗方案，必要时启动糖皮质激素冲击治疗。

Abstract: Objective: To explore the etiology, complications, treatment, and prognosis of refractory hypothyroidism. Method: Analyze the etiology of refractory hypothyroidism combined with thyroid related ophthalmopathy and acromegaly, summarize the research progress on it. Result: Irregular use of levothyroxine in the treatment of hypothyroidism resulted in refractory hypothyroidism, accompanied by thyroid related eye disease and thyroid acromegaly. Adjusting the dosage of levothyroxine and glucocorticoid shock therapy can alleviate its symptoms. Conclusion: Cases of refractory hypothyroidism combined with thyroid related ophthalmopathy and acromegaly are extremely rare, and the reasons are closely related to poor patient compliance, smoking, and positive thyroid autoantibodies. In addition, there may be other reasons that were not observed. When facing such patients, attention should be paid to their risk factors and treatment plans should be adjusted. If necessary, glucocorticoid shock therapy should be initiated.