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Thyroid storm

内分泌

关键词内分泌 临床研究术语 甲状腺疾病

词汇介绍

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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

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

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

影响因子: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.

译文

在第一种情况下,患者意识到她的抑郁加剧,食物摄入减少和过度疲劳。但是,她采用“等待和观察”的方法,认为与甲状腺风暴有关的中枢神经系统症状是精神病学原因。在第二种情况下,患者有心and和胸闷病史。但是,他最初认为症状并没有告知医生。甲状腺风暴是一种致命疾病,需要及早发现和治疗。如果这些患者的心理或身体状况发生了变化,就接受了甲状腺激素的检测,那么我们也许能够更早地发现并治疗他们的甲状腺疾病。甲状腺风暴的中枢神经系统表现可能包括躁动不安,del妄,精神异常,嗜睡,惊厥和昏迷。但是,在甲亢患者中,抑郁,躁狂和焦虑症是最常报告的精神病学发现。这些潜在的机制被认为与交感神经激活,β-肾上腺素能活性增加和自身免疫过程有关。另外,甲状腺激素被认为对大脑中5-羟色胺系统具有调节作用,并诱导对脑组织的直接作用,从而导致脑电图异常。然而,尚不清楚为什么在甲状腺风暴期间出现中枢神经系统表现。在日本,据报道有67.4%的甲状腺风暴患者和84.4%的确诊患者中枢神经系统表现。明确诊断的患者中,超过一半的患者GCS异常(53.5%)和/或日本昏迷量表评分(62.6%)。较低的GCS与不可逆性缺陷的发生密切相关,因此必须正确识别甲状腺风暴患者的CNS表现。