门诊背景人群甲状腺疾病最新调查报告  

Investigation of thyroid diseases in outpatients

作　　者：庞璨[1] 刘风静[1] 李连喜[1] 陈思[1] 赵蔚菁[1] 徐伟斌[1] 屠印芳[1] 贾伟平[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科,上海市糖尿病临床医学中心,上海市糖尿病重点实验室,上海市糖尿病研究所,上海200233

出　　处：《上海医学》2013年第5期421-424,共4页Shanghai Medical Journal

摘　　要：目的调查2012年4月10日-5月9日在上海交通大学附属第六人民医院内分泌代谢科门诊就诊的甲状腺疾病患者的分布及诊治情况。方法收集并分析501例门诊甲状腺疾病患者的一般情况、甲状腺家族史、精神压力程度、摄入富碘食物和含碘盐、甲状腺疾病的诊治情况。结果女性患者占81.4%,其中32.9%的女性患者年龄为>25～35岁。甲状腺功能亢进症(以下简称甲亢)219例(43.7%),甲状腺功能减退症(以下简称甲减)157例(31.3%),甲状腺结节147例(29.3%),桥本甲状腺炎132例(26.3%)。在确诊前摄入含碘盐的患者中49.5%于确诊后改食无碘盐,在确诊前摄入富碘食物的患者中77.5%于确诊后改为偶尔或停止食用富碘食物。有夜间工作的患者确诊前的精神压力程度评分为5.0(3.0,7.0),显著高于无夜间工作患者[3.0(0.0,5.0),P=0.000];确诊后仍继续夜间工作患者的精神压力程度评分[5.0(2.8,7.5)]亦显著高于无夜间工作的患者[2.5(0.0,5.0),P=0.000]。已知甲亢和甲减患者中分别有44.4%和37.8%未行甲状腺B超检查,77.6%的甲亢和68.9%的甲减患者未行或不知晓抗甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)检查。行手术或131I治疗的患者中55.6%在治疗后并发甲减。接受药物治疗的甲亢患者中有20.8%出现药物不良反应。甲亢和甲减患者中有158例治疗2年以上,甲状腺功能未达正常范围者占23.1%。结论相较于甲亢和甲减,桥本甲状腺炎和甲状腺结节在门诊患者中的高比例不容忽视。行甲状腺B超和甲状腺抗体检查的比例偏低。Objective To report the distribution, diagnosis and treatment of thyroid diseases in outpatients in our hospital in 2012. Methods A total of 501 outpatients with thyroid diseases were enrolled in the study. The information, including age, sex, habitual residence, familial history of thyroid diseases, mental stress, iodine-rich food intake, iodine salt intake, diagnosis, laboratory test and treatment, were collected. Results Of the patients, 81.4% were female 3 and 32.9% of the females were aged from 26 to 35 years. There were 219 patients with hyperthyroidism （43.7 % ）, 157 with hypothyroidism （31.3%）, 147 thyroid nodules （29.3%） and 132 with Hashimotos thyroiditis （26.3%）. Up to 49.5% of the patients who used iodized salt changed to non- iodized salt after consulting a doctor, and 77.5% of the patients used to have iodine-rich food quitted or restricted intake. The degree of mental stress before diagnosis in those with night working was significantly higher than those without night working （5.01-3.0, 7.07 vs. 3.01-0.0, 5.01, P = 0. 000）. The degree of mental stress after diagnosis also scored higher in those with night working than those without night working （5.0[2.8, 7.5] vs. 2.51-0.0, 5.07, P = 0. 000）. Up to 44.4 % of the patients with hyperthyroidism and 37.8 % with hypothyroidism did not receive ultrasonography, and 77.6 % of known hyperthyroidism and 68.9 % of known hypothyroidism did not take the analysis of anti-thyroperoxidase antibody （TPOAb） or anti-thyroglobulin antibody （TGAb）. Hypothyroidism occurred in 55.6% of the patients after surgery or ^131I treatment. Drug adverse reaction occurred in 20.8% of thepatients with hyperthyroidism treated with proylthiouracil or methimazole. In the patients with hyperthyroidism and hypothyroidism, 158 had been treated for over 2 years and 23. 1% was in poor control of thyroid function. Conclusion The high incidence of the elevated thyroid nodules and Hashimotos thyroiditis should be noted in addition to hyperthyroidism and hypothy

关 键 词：门诊患者 甲状腺疾病 甲状腺B超 甲状腺抗体 

分 类 号：R581[医药卫生—内分泌]