轻度亚临床甲状腺功能减退症是否需要干预:基于循证医学的思考  

Is interventional therapy in mild subclinical hypothyroidism necessary:thoughts based on evidence

作　　者：张小改 徐书杭[1] 陈国芳[1] 刘超[1] Zhang Xiaogai;Xu Shuhang;Chen Guofang;Liu Chao(Department of Endocrinology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Traditional Chinese Medicine,Jiangsu Province Academy of Traditional Chinese Medicine,Nanjing 210028,China)

机构地区：[1]南京中医药大学附属中西医结合医院(江苏省中医药研究院)内分泌科,210028

出　　处：《国际内分泌代谢杂志》2018年第6期386-389,393,共5页International Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81200577);江苏省“六大人才高峰”项目(2013-WSN-063);江苏省临床医学科技专项一重点病种的规范化诊疗(BL2013040).

摘　　要：亚临床甲状腺功能减退症(SCH)是较为常见的临床疾病,女性发病率大于男性,并随着年龄和促甲状腺激素水平的升高进一步增加。既往的研究发现,即使轻度SCH亦会增加心血管疾病、代谢性疾病和不良妊娠结局等的风险,并且替代治疗可使整体健康获益。但轻度SCH与骨骼肌系统、认知功能异常、情绪障碍、血脂紊乱和糖尿病等之间的联系及其治疗的临床获益仍存在争议。Subclinical hypothyroidism(SCH)is a common problem (prevalence is greater in women than men),which increases further with increasing age and thyroid stimulating hormone level.Previous studies suggested that even though mild-SCH had a detrimental effect on cardiovascular risk factors and metabolic diseases,and increased risk of adverse pregnancy outcomes,and that its effective treatment might have a beneficial impact on overall health.However,evidence on the association of mild-SCH and musculoskeletal system,cognitive dysfunction,mood disorders,dyslipidaemia,and diabetes,and the clinical benefits of treatment are controversial.

关 键 词：亚临床甲状腺功能减退症 左甲状腺素 替代治疗 

分 类 号：R581.2[医药卫生—内分泌]