【作者】 许千；

【导师】 赵占胜；

【作者基本信息】 河北医科大学 ， 内科学， 2010， 硕士

【摘要】 亚临床甲状腺功能亢进症(Subclinical Hyperthyroidism,以下简称亚临床甲亢)是一种特殊类型的甲状腺功能亢进症,是指血游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)正常,促甲状腺素(TSH)低于正常。依病因可分为内源性和外源性两类。结节性甲状腺肿、潜在的Graves病、甲状腺炎及摄入过量的L-T4是其常见的病因。亚临床甲亢临床症状多不明显,但可较早出现心脏和自主神经调节功能受损;心房纤颤发生率高;绝经后女性亚临床甲亢患者骨质疏松危险性增加。该病的诊断应排除引起暂时性TSH降低的其他原因。亚临床甲亢是否治疗要权衡利弊。TSH显著降低者可相应治疗,TSH轻度降低者应定期随访。克氏综合征是一种染色体异常的综合征,一般表现为47, XXY的染色体核型,并常伴有其他脏器、系统的异常。现在我们报道一例克氏综合征伴有代谢综合征的青年男性病人。该患者表现为睾丸发育差,低睾酮,高卵泡刺激素、黄体生成素,无精,婚后不育,染色体核型47, XXY,支持克氏综合征诊断。依其肥胖体型、高血压、高血糖、高血脂,诊为代谢综合征。现结合相关文献复习如下。更多还原

【Abstract】 Subclinical hyperthyroidism is a special kind of hyperthyroidism, as defined by the presence of a low serum TSH level in the face of normal serum free T4 and free T3 levels. According to etiology, it can be divided into two types of endogenous and exogenous subclinical hyperthyroidism. Nodular goiter, the potential Graves disease, thyroiditis, and intake of excessive amount of L-T4 is the common cause of it. Most symptoms of subclinical hyperthyroidism are not obvious, but the heart and autonomic nervous dysfunction can occur early; the incidence of auricular fibrillation raises up; subclinical hyperthyroidism increases risk of osteoporosis in post-menopausal women patients. The diagnosis should be excluded from the disease caused by a temporary reduction in TSH of other causes. The treatment of subclinical hyperthyroidism should be weighed. If there is a noticeable reduction of TSH, we can give the homologous treatment. If TSH has a mild reduction, we should follow up regularly. Klinefelter’s syndrome, characterised by a 47, XXY chromosomal pattern, has largely been associated with physical abnormalities. Here, we report a case of Klinefelter’s syndrome in a 28-year-old man who had metabolic syndrome. We diagnosed him with Klinefelter’s syndrome from his atrophic testicles, primary hypogonadism in hormonal examination, infertility, and a chromosomal aberration of 47, XXY. From the fat somatotypes, high level of blood glucose, blood fat and blood pressure, we diagnosed him with metabolic syndrome. In the end, we review some literatures about Klinefelter’s syndrome and metabolic syndrome.更多还原