甲状腺功能减退症合并慢性肾功能衰竭5例临床分析

目的：提出一些关于早期诊治甲状腺功能减退症合并慢性肾功能不全的建议。方法：回顾性分析我科2000-2006年住院患者中甲状腺功能减退症合并肾功能衰竭病例5例,比较其临床表现和相关检查并分析其诊疗经过。结果：二种疾病不仅在其发生发展上有一定联系,而且在临床表现和相关检查上也有相似之处。二种疾病都可出现浮肿、贫血、乏力、纳差、心包积液、蛋白尿和不同程度的肾功能不全。二者合并出现时临床表现更加复杂多样,增加了临床诊断的难度。结论：在诊治此类疾病时要注意临床表现的一些细节,如心力衰竭时的相对缓脉、与肾功能不全不相适应的贫血、难治性心包积液、不明原因的肾功能损害等,以便早期正确诊治,提高诊疗水平。

Clinical Analysis of Hypothyroidism combined with Chronic Renal Failure

Objective:To offer some suggestions about how to diagnose and treat the early stage of hypothyroidism com- bined with chronic renal failure.Metheds:5 cases with hypothyroidism combined with chronic renal failure,who were selected from the inpatients in our hospital from 2000 to 2006 were reviewed and the clinical manifestations,the course of diagnosis,the re- lated examinations were retrospectivdy analyzed.Results:There were some differences and relationes in clinical manifestation, blood routine,biochemical and endocrinic examinations between hypothyroidism and chronic renal failure.There were some com- mon presentations for hypothyroidism and renal failure,such as edema,anemia,hypodynamia,anorexia,pericardial effusion,pro- teinuria and renal failure.When the hypothyroidism combined with chronic renal failure coexisted,the clinical presentations became more complicated and the diagnosis became more difficult.Conclusion:When hypothyroidism combined with chronic renal fail- ure was diagnosed and treated,one must pay more attention to some subtle difference of clinical manifestations,such as relatively infrequent pulse accompanying with heart failure,anemia not suited to renal inadequacy,refractory hydrocardia and agnogenic re- nal damage.The investigation of those clinical manifestations and laboratory examination is valuable for early and precise diagnosis and treatment of hypothyroidism combined with chronic renal failure.