桥本病的细胞病理学诊断与局部免疫调节治疗的研究  

The cytopathologic diagnosis of Hashimoto's thyroiditis and the efficacy of local immunity regulation therapy

作　　者：王旭波[1] 陆美琪[2] 刘超[3] 石龙姣[1] 阎家新[4] 

机构地区：[1]徐州医学院第二附属医院病理科 [2]徐州医学院第二附属医院内分泌科,江苏徐州221006 [3]南京医科大学第一附属医院内分泌科,江苏南京210029 [4]徐州医学院第二附属医院影像科,江苏徐州221006

出　　处：《徐州医学院学报》2007年第2期93-96,共4页Acta Academiae Medicinae Xuzhou

基　　金：徐州矿务集团科研课题(2005-32WS)

摘　　要：目的观察细胞病理学对桥本病的诊断意义,评价甲状腺局部免疫调节治疗桥本病的疗效。方法对临床、血清学和超声诊断为桥本病的患者行细针针吸细胞病理学诊断。确诊的92例患者分3组:A组31例口服药物治疗;B组31例口服药物加局部免疫调节治疗;C组30例局部免疫调节治疗。结果92例细胞病理学诊断:淋巴细胞型54例,嗜酸性变型21例,上皮破坏型13例,纤维化型5例。3组甲状腺体积缩小,质地变软,血清学恢复和淋巴细胞浸润减轻明显改善;治疗后显示:B、C两组与A组之间比较有显著性差异,B、C组之间比较差异无显著性,B组疗效最佳,C组次之。结论细针针吸细胞病理学诊断桥本病客观、准确、特异。地塞米松局部注射治疗桥本病疗效显著。Objective To comment on the significance of cytopathologic diagnosis of Hashimoto＇ s thyroiditis （HT） and evaluate the curative effect of local immunity regulation for its treatment. Methods 92 patients with HT diagnosed clinically, by serology and uhrasonography, and especially, by fine - needle aspiration biopsy, were divided into 3 groups to undergo varied regimens of treatment. Group A, the control, was treated with conventional oral drugs ; group B, with oral drugs plus local injection of dexamethasone; group C, with local dexamethasone alone. The injection was given once a week, 5 weeks as a course, which was repeated 2 times at 2 - month intervals. The efficacy was assessed by comparing the biochemical, ultrasonic and cytological findings before and after the treatment. Results The curative effects were significantly better in groups B and C than in group A （ P 〈 0.05 ）, with that in group B as the best, although the difference in effects was insignificant between groups B and C. Conclusion The exfoliative and aspiration cytopathology for diagnosing HT is objective, accurate and specific. Local dexamethasone immunity regulation therapy for HT is obviously efficacious.

关 键 词：桥本病 细胞病理学 局部免疫 司节治疗 地塞米松 

分 类 号：R581.4[医药卫生—内分泌] R361.3[医药卫生—内科学]