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1、老年人甲亢性肝损害临床特点分析【关键词】甲状腺功能亢进症；，肝疾病；，老年人,，【摘要】目的探讨老年人甲亢性肝损害（HLI）的发病特点、临床和关因素及其防治策略。方法対1994年4月至2004年12月在我院诊治的45例老年甲亢住院患者进行冋顾性调查，分析病程中发生肝损害的情况。结杲45例老年甲亢住院患者中，并发HLI26例，发生率5778%OHLI发生率与患者的年龄、病程、并发症严重程度、治疗是否及吋有效等密切相关，而与性别无关。临床症状不典型。在采取卧床休息、保川：、降酶及支持治疗的同吋，分别给予抗甲状腺药物、放射性131碘、手术等治疗控制原发病，并防治并发症。随访肝功能18例恢复
2、止常，4例明显好转，治疗有效率8462%；另4例因延误诊治而病情加重。结论只有提高医生对老年人HLI的认识，加强原发病的治疗，合理选用治疗方案，才能减少并预防HLI的发生。【主题词】甲状腺功能亢进症；肝疾病；老年人ClinicalfeaturesofhyperthyroidismliverinjuryintheelderlyYINShuming,YUXiaofeng,WANGYiqian,GUTongjin,YOUChuanyi,WANGGensheng.DepailmentofGastroenterology,HuadongHospital,Shanghai200040China[
3、Abstract]ObjectiveToevaluatethecharacteristics,theclinicalfactorsandthepreventionandtherapenticmeasuresofhyperthyroidismliverinjury（HLI）intheelderly.MethodsClinicalrecordsof45hospitalizedelderlypatientswithhyperthyroidismfromApril1,1994toDecember31,2004werestudiedretrospectively.Inallpatients,t
4、heconditionsaboutliverinjuryinthecourseofdiseaseswereanalyzed.Resu1tsOfthe45elderlypatientswithhyperthyroidism,26presentedwithHLI,withaprevalencerateof5778%.TheseverityofHLIwassignificantlycorrelatedwithage,courseofdisease,degreeofcomplicationsbuttreatmentbutnotcorrelatedwithsex.Theclinicalsymp
5、tomsofHLIintheelderlywasatypical.Whilethepatientswereaskedtostayinbedandgiventreatmentofprotectingtheliver,loweringlevelsofserumtransaminaseaswellassupportivetherapy,allthepatientsweretreatedwithantithyroiddrugs（ATD）,radioactiveiodine（1311）andsurgerytocontroltheprimarydiseasealongwithpreventiio
6、nofcomplications.Afterthetreatment,ofthe26patients,18turnednormaland4showedsignificantefficacy.Theimprovementratewas8462%,andanother4aggravatedbecauseofdelayingtreatment.ConclusionsItisimportanttoreduceandpreventHLIintheelderlywithhyperthyroidismbystrengtheningthetreatmentfortheprimaryaffection
7、,andusingreasonableprogram.[Subjectwords]Hyperthyroidism；Liverdiseases;Aged原发性甲状腺功能亢进症并发肝脏功能损害（简称：甲亢性肝损害，HLI）临床上并不少见，而老年HLI患者由于症状多不典型，尤其在并发症表现较突出时易造成漏诊、误诊。我们冋顾分析26例确诊的老年HLI患者的住院病史资料，对其发病特点、临床相关因素、防治策略进行总结，现将结杲报道如下。1资料与方法11一般资料1994
