摘要
目的分析亚急性甲状腺炎的发病原因、临床特征、诊断方法和治疗措施。方法对41例亚急性甲状腺炎住院患者的流行病学特点、临床特征、治疗方法和结果进行回顾性分析。结果亚急性甲状腺炎以40~50岁女性多见,秋冬季为多,约占60%;病因可能和病毒感染有关;多数患者有发热、头痛等全身症状,单侧甲状腺肿大和触痛很常见,68.3%患者有高代谢表现,血沉明显增快,大于50%患者出现血清TT3、TT4、FT3、FT4高于正常。90.2%患者的24 h甲状腺摄131I率小于10%;糖皮质激素和非甾体类抗炎药物对本病的疗效显著,少数患者出现糖皮质激素相关的高血压、血糖升高、低钾麻痹和精神症状。结论亚急性甲状腺炎的发病率近年来有所增加,临床表现易与多种疾病混淆,需认真评判甲状腺功能并结合组织活检准确诊断。肾上腺皮质激素对于该病疗效好,需仔细观察、及时处理一些可能的并发症。
Objective To explore the cause,clinical characteristics,diagnosis,and treatment of subacute thyroiditis（SAT）.Methods The epidemiological features,clinical features,treatments and clinical outcomes of 41 hospitalized patients with subacute thyroiditis were analyzed retrospectively.Results SAT occurred commonly in women aged 40 to 50 years old.60% patients sufferred from SAT in fall and winter.The pathogenesis of SAT may be correlated with virus infection.Glucocorticoids and Non-Steroidal antiinflammatory drugs were effective in treatment of SAT.Most patients had fever,headache,and systemic symptoms.Unilateral thyroid gland enlargement and tenderness were very common in these cases.68.3% of the patients had high metabolic manifestations.In these cases,erythrocyte sedimentation rate（ESR） significantly increased,more than 50% of patients experienced higher serum total triiodothyronine（TT3）,total thyroxine（TT4）,free triiodothyronine（FT3） and free thyroxine（FT4） levels than normal.90.2% patients experienced less than 10% of thyroidal uptake rate of 131I at 24 hours.Infrequent and glucocorticoids related side effects such as high blood pressure,high blood sugar,low potassium palsy and mental symptoms occurred in some patients.Conclusion Morbidity of SAT had increased in recent years,its clinical manifestations was usually confused with other diseases.We should make the diagnosis accurately by combining evaluation of thyroid function and biopsy.Adrenal cortical hormone was effective treatment on SAT,but we should observe the possible complications carefully and handle them timely.
出处
《中华全科医学》
2011年第7期1012-1013,1065,共3页
Chinese Journal of General Practice
基金
安徽省卫生厅临床医学应用技术项目(06B091)
关键词
亚急性甲状腺炎
临床特征
诊断
治疗
Subacute thyroiditis
Clinical Characteristics
Diagnosis
Treatment
