内分泌
词汇介绍
拓展阅读
解析
Thyroid 英 /ˈθaɪrɔɪd/ 美 /ˈθaɪrɔɪd/
释 义 n. 甲状腺；甲状软骨；甲状腺剂
adj. 甲状腺的；盾状的
例 句 I believe that thyroid hormone treatment should not be given to all overweight subjects. 我相信甲状腺激素治疗并不适用于所有的肥胖病人。
Storm 英 /stɔːm/ 美 /stɔːrm/
释 义 n. 暴风雨；大动荡
vi. 起风暴；横冲直撞；狂怒咆哮
vt. 猛攻；怒骂
n. (Storm)人名；(瑞典)斯托姆；(德)施托姆；(英、西、芬)斯托姆
同根词 stormy adj. 暴风雨的；猛烈的；暴躁的
storminess n. 风暴度；磁暴度；猛烈
例 句 It could, however, be the calm before the storm. 然而，那可能是暴风雨前的平静。
概述
概述
甲状腺危象是一种危及生命的健康状况，与未经治疗或治疗不足的甲状腺功能亢进有关。在甲状腺危象期间，一个人的心率，血压和体温会飙升到危险的高水平。如果没有及时、积极的治疗，甲状腺危象通常是致命的。甲状腺是位于下颈部中间的小蝴蝶形腺体，甲状腺产生的两种必需甲状腺激素是三碘甲状腺素（T3）和甲状腺素（T4）。这些激素控制着人体中每个细胞的运转速度（新陈代谢）。如果患有甲状腺功能亢进症，那么就会产生过多的这两种激素。
病理原因
甲状腺危象很少见，它会在患有甲亢但未得到适应治疗的人中发展。这种状况的特征是甲状腺会过度产生两种激素，并非所有患有甲状腺功能亢进症的人都会发展为甲状腺危象。发生这种情况的原因包括：严重的甲状腺功能低下；未经治疗的甲状腺活动过度；甲亢相关的感染。甲状腺功能亢进症患者可能会出现以下情况之一而发展为甲状腺危象：外伤、手术、严重的情绪波动、糖尿病酮症酸中毒、充血性心力衰竭、肺栓塞等。
诊断
甲状腺功能亢进症患者如果遇到任何甲状腺危象的症状，通常会被送往急诊室。如果您怀疑自己或其他人有甲状腺危象的症状，请立即拨打急救电话。甲状腺危象患者通常会表现出心率加快以及最高血压值（收缩压）升高的现象。
医生会通过验血来测量甲状腺激素水平。在甲状腺功能亢进症和甲状腺危象中，甲状腺刺激激素（TSH）水平往往较低。根据美国临床化学协会（AACC），TSH的正常值范围为每公升0.4至4毫国际单位（mIU/L）。甲状腺危象患者中的T3和T4激素高于正常人。
治疗
甲状腺危象发展迅速，并影响身体的所有系统。怀疑有甲状腺危象后将立即开始治疗-通常在实验室结果全部出来之前。将给予抗甲状腺药物，如丙硫氧嘧啶（也称为PTU）或甲巯咪唑（他巴唑），以减少甲状腺产生的这些激素。甲状腺功能亢进症需要不断的护理。甲状腺功能亢进症患者可以接受放射性碘治疗，它会破坏甲状腺，或使用一些药物来暂时抑制甲状腺功能。甲状腺功能亢进的孕妇不能接受放射性碘治疗，因为碘会伤害未出生的孩子。在这些情况下，将通过手术切除该妇女的甲状腺。经历甲状腺危象的人应避免服用碘代替医疗，因为这会使病情恶化。如果甲状腺因放射性碘治疗而被破坏或通过外科手术切除，则一生中将需要服用合成甲状腺激素。
The Delayed Diagnosis of Thyroid Storm in Patients with Psychosis: A Report of Two Cases
复制标题
精神病患者甲状腺风暴的延迟诊断 (附2例报告)
发表时间：2019-08-01
影响指数：1.0
作者： Yuki Ishihara
期刊：Intern Med
In the first case, the patient recognized worsening of her depression, a decreased food intake, and extensive fatigue. However, she adopted the “wait and see” approach, presuming her CNS symptoms associated with thyroid storm to be psychiatric in origin. In the second case, the patient had a history of palpitation and chest tightness. However, he initially discounted the symptoms and not informed his doctor. Thyroid storm is a lethal disease that requires early detection and treatment. If these patients had undergone thyroid hormone measurements when their mental or physical statuses had changed, we might have been able to detect and treat their thyroid conditions earlier. CNS manifestations of thyroid storm may include restlessness, delirium, mental aberration, somnolence, convulsions, and coma. However, depression, hypomania, and anxiety disorders are the most frequently reported psychiatric findings in patients with hyperthyroidism. The mechanisms for underlying these are thought to involve sympathetic nerve activation, increased β-adrenergic activity, and the autoimmune process. In addition, thyroid hormones are thought to have a modulating effect on the serotonin system in the brain and induce direct effects on cerebral tissue, which cause electroencephalogram abnormalities. However, why CNS manifestations appear during a thyroid storm are unclear. In Japan, CNS manifestations were been reported in 67.4% of patients with thyroid storm and 84.4% of patients with a definite diagnosis. More than half of patients with a definite diagnosis had an abnormal GCS (53.5%) and/or Japan Coma Scale score (62.6%). A lower GCS has been significantly associated with the development of irreversible deficits, making it essential that we correctly identify CNS manifestations in patients with a thyroid storm.
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