经病理确诊的亚急性甲状腺炎182例临床分析  

Subacute thyroiditis diagnosed by pathology:a clinical analysis of 182 cases

作　　者：赵志勇[1] 韦玉和[1] 冯小芬[1] 薛志新[1] 

机构地区：[1]江苏大学附属武进医院内分泌科,江苏常州213002

出　　处：《中国现代医学杂志》2015年第20期83-86,共4页China Journal of Modern Medicine

摘　　要：目的探讨病理检查在亚急性甲状腺炎（SAT）诊治中的重要性。方法回顾性分析2008-2012年经病理确诊的SAT 182例,分析血沉（ESR）、甲状腺功能、彩超、摄碘率等。结果 2010年后SAT发病率上升,40-49岁高发,女性好发,夏秋季为发病相对高峰期;168例经甲状腺细针穿刺细胞学（FNAC）确诊,14例手术后病理确诊;甲状腺功能异常为161例（89.01%）,总甲状腺素（TT4）和血清游离甲状腺素（FT4）阳性率分别高于甲状腺原氨酸（TT3）和游离三碘甲状腺原氨酸（FT3）（P〈0.01）;ESR增高率达97.02%,阳性率较TT4、FT4和血清促甲状腺素（TSH）阳性率有显著增高（P〈0.01）;超声诊断与FNAC相符率为76.90%;131I摄取阳性率为80%。结论 SAT发病有上升趋势,FNAC是诊断SAT的重要手段之一,简便易行,准确性高,值得推广。[ Objective] To investigate the importance of pathological examination in diagnosis and treatment of subaeute thyroiditis （SAT）. [Methods] A total of 182 patients with SAT confirmed by pathological examination from 2008 to 2012 were retrospectively evaluated, and erythroeyte sedimentation rate （ESR）, thyroid function, thyroid ultrasound, iodine uptake, etc were retrospectively examined. [Results] The incidence of SAT increased after 2010. It oeeured most often in middle-aged women form 40 to 49 years, and the peak incidence of SAT appeared in summer and autumn. Among the182 cases, 168 eases were diagnosed by fine-needle aspiration cytology （FNAC）, 14 cases were confirmed by postoperative pathological diagnosis. Tthyroid dysfunction was found in 161 of 182 patients （89.01%）, the positive rates of TT4 and FT4 were higher than those of TT3 and FT3 retrospectively （P〈 0.01）. The elevated ESR rate was 97.02%, which was significantly higher than the positive rates of FT4, Tr4 and TSH （P〈 0.01）. The consistent rate of ultrasound diagnosis with FNAC was 76.90%. The positive rate of ^131I uptake was 80%. [Conclusion] The incidence of SAT is on the rise. FNAC is one of important methods for diagnosis of SAT, which is worth promoting for its simplicity and high accuracy.

关 键 词：亚急性甲状腺炎 细针穿刺细胞学 临床分析 

分 类 号：R581.4[医药卫生—内分泌]