摘要
目的通过对我院1例合并颅内动脉瘤的桥本甲状腺炎致双侧眼肌麻痹患者的临床资料进行分析，提高对该病的认识，防止误诊、漏诊。方法回顾性分析徐州医科大学附属医院于2012年9月收治的1例桥本甲状腺炎合并双侧眼肌麻痹患者的临床资料。结果该患者双侧眼肌麻痹，右侧重；甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）呈高滴度；甲状腺B超示：甲状腺增大，回声不均匀，甲状腺左侧叶多发不均质回声结节；头颅MRI示：双侧眼外肌及视神经萎缩；头颅血管成像（CTA）示：右侧颈内动脉床突段动脉瘤表现。经右侧颈内动脉瘤栓塞术治疗后症状缓解不明显，予以激素冲击、改善循环、营养神经等综合治疗后症状好转，考虑系桥本甲状腺炎累及眼外肌所致。结论桥本甲状腺炎可能引起眼肌麻痹性损伤，神经内科医生需要高度警惕此病，防止漏诊。
Objective To analyze the clinical data of a Hashimoto thyroiditis caused bilateral ophthalmoplegia patient with intracranial aneurysm in our hospital, so as to enhance the understanding of the disease and prevent misdiagnosis. Methods The clinical data of a Hashimoto thyroiditis caused bilateral ophthalmoplegia patient with intracranial aneurysm who were admitted into the Affiliated Hospital of Xuzhou Medical University in September 2012 were retrospectively analyzed. Results The patient presented bilateral ophthalmoplegia, especially on the right side; high titers of anti - thyroid globulin antibody （TGAb） and anti -thyroid peroxidase antibody （TPOAb） ; enlarged thyroid with uneven echo and multiple heterogeneous echogenic nodules in the left lobe of the thyroid gland according to thyroid uhrasonography; bilateral extraocular muscle and optic atrophy according to cerebral MRI; and right internal carotid artery aneurysm according to cerebral vascular imaging （CVA）. After embolization of the right internal carotid artery, the patient＇s symptoms were not remarkably relieved, but then gradually improved after hormone shock, improved circulation and nerve nutrition. Such incompletely relieved symptoms might be caused by Hashimoto thyroiditis which affected extraoeular muscles. Conclusions Hashimoto thyroiditis may cause ophthalmoplegic injury. Neurologists need to be on the alert to prevent misdiagnosis.
出处
《徐州医学院学报》
CAS
2017年第2期115-117,共3页
Acta Academiae Medicinae Xuzhou
基金
国家自然科学基金面上项目（81571469）
国家自然科学基金面上项目（81271268）
关键词
眼肌麻痹
桥本甲状腺炎
颅内动脉瘤
ophthalmoplegia
Hashimoto thyroiditis
intracranial aneurysm
