CAJ | 학술논문

目的：通过对2例甲状腺功能减退（甲减）导致的呼吸或循环衰竭的临床病例报告，复习甲减导致呼吸、心力衰竭的机制等，进而提高对甲减相关性呼吸、心力衰竭的诊治水平。方法回顾性分析福建省立医院收治的2例以呼吸衰竭、心力衰竭为主要表现的2例甲减患者的临床特点，并进行相关文献回顾。结果病例1报道了患者先后两次间隔9个月均因甲减危象并发呼吸衰竭而入院诊治的过程。病例2报道了甲减患者以心力衰竭主要并发症诊治过程。结论两例均为女性患者，均因肺部感染导致急性发病，但分别以呼吸、心血管系统不同程度受累为主要表现，提示甲减首发危及生命的并发症可能跟个体心肺代偿功能，甲减发展速度、严重程度等相关。同时，甲减导致呼吸衰竭、心力衰竭是临床中少见且容易漏诊、误诊的危重症，应引起临床医师的重视。
목적：통과대2례갑상선공능감퇴（갑감）도치적호흡혹순배쇠갈적림상병례보고，복습갑감도치호흡、심력쇠갈적궤제등，진이제고대갑감상관성호흡、심력쇠갈적진치수평。방법회고성분석복건성립의원수치적2례이호흡쇠갈、심력쇠갈위주요표현적2례갑감환자적림상특점，병진행상관문헌회고。결과병례1보도료환자선후량차간격9개월균인갑감위상병발호흡쇠갈이입원진치적과정。병례2보도료갑감환자이심력쇠갈주요병발증진치과정。결론량례균위녀성환자，균인폐부감염도치급성발병，단분별이호흡、심혈관계통불동정도수루위주요표현，제시갑감수발위급생명적병발증가능근개체심폐대상공능，갑감발전속도、엄중정도등상관。동시，갑감도치호흡쇠갈、심력쇠갈시림상중소견차용역루진、오진적위중증，응인기림상의사적중시。
Objective in order to improve the accurate diagnosis rate as well as the treatment in the hypothyroid related critical illness, two cases of respiratory and heart failure caused by severe hypothyroidism were emphasized and the mechanism was reviewed in the literature.Method Two typical cases of hypothyroid which respectively caused the critical injury of the respiratory and circulatory systems were extracted from fujian Provincial Hospital databases of inpatients. They were retrospectively analysed and reviewed.Resultcase 1 shows a 60-year-old woman who presented mainly as refractory respiratory failure of unknown origin in the two admissions with an interval of nine months, which finally turned out to be the complication of the underlying disease- hypothyroidism crisis. case 2 shows a 84 -year-old lady manifested as hypothyroid related heart failure. Both patients have recovered from the replacement of levothyroxine.Conclusion The respiratory and circulatory system injury triggered by pulmonary infection were separately present in the two cases of female patients. it indicates that the life-threatening complications as the first presentation of hypothyroidism are likely to be associated with the individual pulmonary and cardiac function, the developing speed of hypothyroidism and its severity. it requires clinicians to pay more attention to the critical illness and emergency state of respiratory and heart failure resulting from hypothyroidism which can be easily overlooked and misdiagnosed .