甲状腺功能亢进症患者中桥本甲状腺炎的比例及其生化和病理特征  

The Proportion,Biochemical and Pathological Characteristics of Hashimoto's Thyroiditis in Hyperthyroidism

作　　者：何珂[1] 胡源[1] 朱丽华[1] 陆西宛[1] 毛晓明[2] HE Ke HU Yuan ZHU Li-hua LU Xi-wan MAO Xiao-ming(Department of Endocrinology, Medicine, Wuxi 214000, China Department of Endocrinology, 210001, China Wuxi Hospital of Chinese Medicine, Wuxi Hospital Affiliated to Nanfing University of Chinese Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical Hospital, Nanjing 210001, China)

机构地区：[1]江苏省无锡市中医医院南京中医药大学无锡附属医院内分泌科,214000 [2]江苏省南京市第一医院南京医科大学附属南京医院内分泌科,210001

出　　处：《中国全科医学》2017年第2期214-218,共5页Chinese General Practice

摘　　要：目的观察临床上诊断为毒性弥漫性甲状腺肿(GD)的甲状腺功能亢进症(甲亢)患者术后病理中桥本甲状腺炎(HT)的比例,评估甲亢患者中HT的比例及其生化、病理特征。方法选取2012—2014年于南京市第一医院内分泌科及甲乳外科临床诊断为GD的甲亢患者36例,甲状腺切除术后甲状腺组织常规送病理检查,观察术后病理GD、HT、GD+HT的比例及其生化、病理特征。结果 36例甲亢患者术后病理中,26例(72.2%)为GD,7例(19.5%)为HT,3例(8.3%)为GD+HT。3组患者性别、年龄、病程、促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT-_3)、游离甲状腺素(FT_4)、促甲状腺素受体抗体(TRAb)水平比较,差异均无统计学意义(P>0.05);3组患者甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平比较,差异均有统计学意义(P<0.05),其中GD+HT组TPOAb水平高于GD组,HT组和GD+HT组TGAb水平高于GD组(P<0.05)。结论 HT在甲亢患者中占一定比例,HT和GD+HT可能是GD进展为HT的不同发展阶段。Objective To investigate the proportion of histopathologically confirmed Hashimoto＇s thyroiditis（ HT） in clinically diagnosed Graves＇ disease（ GD） patients with hyperthyroidism,and evaluate the biochemical and pathological characteristics.Methods From 2012 to 2014,thirty-six patients with hyperthyroidism who were clinically diagnosed as GD in the Department of Endocrinology and Thyroid-breast Surgery at Nanjing First Hospital accepted thyroidectomy.The thyroid tissues accepted routinely pathological examination after the surgery.The proportions of GD,HT,and GD ＋ HT were calculated and the biochemical and pathological features were analyzed.Results In all 36 patients with hyperthyroidism,26（ 72.2%） of them were GD confirmed by histopathology,7（ 19.5%） were HT,and 3（ 8.3%） were GD ＋ HT.There were no statistically significant differences in gender,age,course of disease,TSH,FT_3,FT_4 and TRAb level among the three groups（ P〈0.05）.There were statistically significant differences in TPOAb and TGAb level among the three groups（ P〈0.05）.The TPOAb level in GD ＋ HT group was higher than that in GD group,and TGAb level in HT group and GD ＋ HT group were higher than that in GD group（ P〈0.05）.Conclusion HT accounted for a certain proportion in hyperthyroidism.HT and GD ＋ HT might be the different stages in the development from GD to HT.

关 键 词：格雷夫斯病 桥本病 甲状腺功能亢进症 

分 类 号：R581.1[医药卫生—内分泌] R392.6[医药卫生—内科学]