Hyperthyroid myopathy and the response to treatment.
Hyperthyroid myopathy and the response to treatment.
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DOI：
10.1089/thy.1991.1.137
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发表时间：
1991-01-01
期刊：
影响因子：
--
通讯作者：
Levey, G S
中科院分区：
文献类型：
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作者：
Olson, B R;Klein, I;Levey, G S
甲状腺功能亢进症伴随着近端和远端骨骼肌的显著功能障碍。本研究的目的是量化新诊断的Graves病患者的肌无力程度，并评估对治疗的反应。10例患者进行了前瞻性研究，客观措施的力量和耐力的近端和远端肌肉，而甲状腺功能亢进症（I期），普萘洛尔2周后（II期），约6个月后，甲状腺功能正常（III期）。普萘洛尔治疗2周导致虚弱的主观减轻，并伴随着握力（P <0.01）、肩部力量（P <0.02）和握力耐力（P <0.01）的统计学显著改善，但肩部耐力没有改善。当患者的化学和临床甲状腺功能正常时，肌肉功能进一步改善并达到控制水平。相比之下，对照组在普萘洛尔治疗1周前后接受相同的肌肉测试方案，显示握力、肩部力量或肩部耐力没有改善，但握力耐力降低（P <0.01），主观虚弱增加。这些结果证实，肌肉无力通常与甲状腺功能亢进症有关，并且在数量上可能很严重。与β受体阻滞剂在正常对照组中的作用相反，普萘洛尔部分改善了甲状腺功能亢进患者的肌无力。我们的结论是甲状腺激素和儿茶酚胺在音乐会介导甲状腺功能亢进症的肌肉功能障碍。
Hyperthyroidism is accompanied by significant dysfunction of both proximal and distal skeletal muscles. The purpose of this study was to quantitate the degree of muscle weakness in newly diagnosed patients with Graves' disease and to assess the response to treatment. Ten patients were prospectively studied with objective measures of strength and endurance of proximal and distal muscles while hyperthyroid (stage I), after 2 weeks of propranolol (stage II), and about 6 months later when euthyroid (stage III). Propranolol treatment for 2 weeks resulted in a subjective decrease in weakness, which was accompanied by a statistically significant improvement in grip strength (P less than 0.01), shoulder strength (P less than 0.02), and grip endurance (P less than 0.01) but not shoulder endurance. Muscle function further improved and attained control levels when the patients were chemically and clinically euthyroid. In contrast, a control group subjected to the same muscle testing protocol before and after 1 week of propranolol treatment showed no improvement in grip, shoulder strength, or shoulder endurance but had decreased grip endurance (P less than 0.01) and increased subjective weakness. These results confirm that muscle weakness commonly is associated with hyperthyroidism and can be quantitatively profound. In contrast to the effects of beta-blockade in normal controls, propranolol partially improves muscle weakness in thyrotoxic patients. We conclude that thyroid hormone and catecholamines in concert mediate the muscle dysfunction of hyperthyroidism.