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目的对肌酸激酶异常升高的16例甲减病例进行综合分析减少误诊、漏诊的发生。方法应用左旋甲状腺素钠(优甲乐)替代治疗,均从小剂量开始,每2～4周复查甲功、心肌酶谱、肝功能,逐渐将优甲乐调整至维持量,观察12周。结果经优甲乐替代治疗后FT3、FT4逐渐升高,TSH逐渐下降,心肌酶谱亦逐渐下降,最后均恢复至正常水平。提示16例患者均为甲减可引起的心肌酶增高。结论在临床提高警惕,注意患者的低代谢症侯群将减少漏诊和误诊的发生。
Objective To conduct a comprehensive analysis of 16 cases of hypothyroidism with abnormally elevated creatine kinase to reduce the occurrence of misdiagnosis and missed diagnosis. Methods The patients were treated with L-thyroxine sodium (Euthyrox) instead of low-dose. The thyroid function, myocardial enzymes and liver function were evaluated every 2 to 4 weeks. Euthyrox gradually was adjusted to the maintenance dose for 12 weeks. Results After treatment with Euthyrox, FT3 and FT4 gradually increased, TSH gradually decreased, and myocardial enzymes also gradually decreased, and finally recovered to normal levels. Tip 16 patients were hypothyroidism can cause increased myocardial enzymes. Conclusions In the clinical vigilance, pay attention to patients with low metabolic syndrome will reduce the missed diagnosis and misdiagnosis.