患者40岁,住院号48370.因消瘦、乏力、记忆力减退、怕冷3年余,于1980年10月3日入院.患者于1979年3月因右侧输卵管壶腹部妊娠40余天破裂,出血大约1000ml,致出血性休克在本院手术治疗.此后渐感体力不支,纳差,体重减轻约10kg,记忆力明显减退,并怕冷、便秘、脱发、月经量减少、皮肤干燥、失眠以致难以支持工作.因上述症状加重,诊断不明入院.体检:T36.6℃,P62次/分,Bp12/8kPa。体重40kg.发育正常,营养欠佳,消瘦,发稀,乳晕色泽正常,皮肤色索脱失不明显.浅表淋巴结未触及.甲状腺不大,余正常.实验室检查:甲状腺素(T_4)70.8nmol/L,甲状腺吸~(131)Ⅰ率2小时13.7%,24小时为36.93%,抗甲状腺球蛋白抗体1:128,抗微粒体抗体1:256.空腹血糖6.22mmol/L,肌红蛋白0.94nmol/L.肝功、血脂及电解质均正常.阴道细胞学检查三次均示雌激素轻度 40 years old, hospital number 48370. Because of weight loss, fatigue, memory loss, more than 3 years afraid of cold, admitted on October 3, 1980. Patients in March 1979 due to the right tubal ampulla of more than 40 days of pregnancy rupture, bleeding about 1000ml, resulting in hemorrhagic shock in our hospital surgery. Since then gradually feel tired, anorexia, weight loss of about 10kg, memory was significantly reduced, and fear of cold, constipation, hair loss, reduced menstrual flow, dry skin, insomnia and hard to support the work Due to the above symptoms, the diagnosis of unknown admission. Physical examination: T36.6 ℃, P62 beats / min, Bp12 / 8kPa. Body weight 40kg. Normal development, poor nutrition, weight loss, thinning, normal areola color, skin color loss is not obvious. Superficial lymph nodes not touched. Thyroid is not large, more than normal. Laboratory tests: thyroid hormone (T_4) 70.8 nmol / L, thyroid uptake rate of 131I was 13.7% in 2 hours, 36.93% in 24 hours, anti-thyroglobulin antibody 1:12 and anti-microsomal antibody 1: 256. Fasting plasma glucose 6.22mmol / L, myoglobin 0.94nmol / L. Liver function, blood lipids and electrolytes were normal vaginal cytology three times showed mild estrogen