甲亢中的散发型无痛性甲状腺炎  

Sporadic Type of Painless Thyroiditis in Hyperthyroidism

作　　者：王国华[1] 邓爱民[1] 王毅飞[1] 张松[1] 金文胜[1] 

机构地区：[1]中国人民解放军广州军区广州总医院,中国广东广州510010

出　　处：《湖南医学》2001年第5期321-323,共3页Hunan Medical Journal

摘　　要：目的探讨散发型无痛性甲状腺炎 (SPT)的发病率 ,实验室检查特征及有关治疗对其临床转归的影响。方法从以典型甲亢症状初诊的 2 19例患者中 ,鉴别出来SPT 37例 ,随机分为治疗组( 2 0例 )及对照组 ( 17例 )进行观察 ,并与Graves病、Plummer病及桥本病相比较。结果SPT的发病率为 16 .9% ,其有关实验室检查有别于上述其他疾病。对照组的甲状腺毒症期为 ( 6 9.5±11.5 )d ,正常甲状腺素血症期为 ( 30 .5± 6 .5 )d ,低甲状腺素血症期为 ( 12 3 .5± 2 4.5 )d。随访 2年期间 2例 ( 11.8% )复发 ,1例遗留永久性甲减。治疗组甲状腺毒症期为 ( 36 .5± 3 .5 )d ,并一直维持正常甲状腺功能而不出现甲减 ,随访期仅 1例( 5 .0 % )复发而未发现永久性甲减。结论在甲亢中SPT仅次于Graves病而较Plummer病及桥本病多见 ,通过有关实验室检查可鉴别 ,适当治疗能较快控制甲亢及降低复发率 。ObjectiveTo investigate the incidence of sporadic type of painless thyroiditis (SPT) and its characteristics of laboratory examination as well as the effects of treatment on its clinical results. MethodsThirty-seven SPT cases were differentiated from 219 patients showing typical symptoms of hyperthyroidism. They were divided randomly into treated group (20 casess) and control group (17 cases), comparing simultaneously with Graves' disease, Plummer's disease and Hashimoto's disease. ResultsThe incidence of SPT was 16.9%. The results of its laboratory examination were different from those of above three diseases. In control group, the duration of thyrotoxicosis continued for 69.5±11.5 days, whereas that of euthyroxinemia and hypothyroxinemia were 30.5±6.5 and 123.5±24.5 days respectively. Having followed-up for two years, recurrence occurred in 2 patients ( 11.8 %) and permanent hypothyroidism was left in one patient. In the treated group, the thyrotoxicosis continued for 36.5±3.5 days, with maintenance of euthyroidism and no appearance of hypothyroidism; just one patient had recurrence (5.0 %) and no permanent hypothroidism was left. Conclusions Among hyperthyroidism, the incidence of SPT is only lower than that of Graves' disease and higher than Plummer's / Hashimoto's disease. The laboratory examinations can help their differential diagnosis. Suitable treatment of SPT may control hyperthyroidism earlier and reduce its rate of recurrence and permanent hypothyroidism.

关 键 词：甲状功能亢进症 诊断 甲状腺炎 治疗 发病率 

分 类 号：R581.1[医药卫生—内分泌] R581.4[医药卫生—内科学]