超声低回声在产后甲状腺炎中的临床意义  

Clinical Value of Thyroid Hypoechogenicity in Patients with Postpartum Thyroiditis

作　　者：范晨玲[1] 李玉姝[1] 关海霞[1] 滕颖[2] 李晨阳[2] 单忠艳[1] 滕卫平[1] 

机构地区：[1]中国医科大学附属第一医院内分泌研究所内分泌科,沈阳市110001 [2]沈阳市第五人民医院妇产科

出　　处：《中国超声医学杂志》2006年第1期19-22,共4页Chinese Journal of Ultrasound in Medicine

基　　金：本课题为国家自然科学基金(No.30370680);辽宁省科技计划项目基金(No.2003225005);辽宁省教育厅课题基金(No.202013158)资助

摘　　要：目的探讨产后甲状腺炎(PPT)病程中甲状腺回声的变化特点及其临床意义。方法对来自流行病学随访研究的300例正常产妇及28例确诊的PPT患者动态观察了甲状腺超声影像变化。结果(1)PPT患者产后6个月病程中甲状腺超声低回声的出现率达到61%,显著高于正常产妇(P<0.01);(2)甲状腺过氧化物酶抗体(TPOAb)阳性的PPT患者甲状腺低回声的出现率达到80%;(3)PPT患者甲状腺超声出现低回声改变时发生甲减的比例(61.9%)及TPOAb的阳性率(100%)最高;(4)PPT患者甲状腺回声正常或仅有回声不均表现者,在产后12个月时甲状腺功能多恢复正常;但是产后6个月时表现为低回声者,产后12个月时30%患者仍遗留TSH异常。结论PPT患者的甲状腺超声特征性表现是低回声。超声显像提示甲状腺的损伤程度与甲功异常、TPOAb升高有关,也证实了超声是预测PPT病程发展变化简单有效的方法。Objective To determine the changes of thyroid uhrasonography （u/s） in paitents with postpartum thyroiditis （PPT） during the first postpartum （pp） year and its clinical significance. Methods Three hundred normal postpartum women and 28 diagnosed clinical PPT patients from an epidemiological survey on PPT accepted thyroid uhrasonographic examination. Results （1） Incidence of hypoechogenicity in PPT patients was significantly higher than that in controls during the 6 months after delivery （61% vs. 3%, P〈0.01） . （2） Incidence of hypoechogenicity in PPT with positive thyroid peroxidase antibody （TPOAb） was 80%. （3） When PPT patients appeared low echo in thyroid （u/s）, hypothyroidism and positive TPOAb was seen in 61.9% and 100% of them, respectively. （4） PPT with normal or only heterogenicity echoheterogenicity in thyroid （u/s） recover to euthyroid at the 12th pp. But 30% of PPT with hypoechogenicity at the 6th pp remained abnormal TSH at the 12th pp. Conclusions The characteristic appearance on thyroid u/s of PPT patients was hypoehogenicity. The ultrasound echogenic texture of thyroid destruction was related to hypothyroidism and elevated TPOAb level. The value of thyroid ultrasound in predicting the change of PPT was verified.

关 键 词：产后甲状腺炎 回声不均 低回声 甲状腺过氧化物酶抗体 

分 类 号：R445.1[医药卫生—影像医学与核医学]