不同类型住院甲状腺功能亢进症患者的临床特征分析  

The Clinical Characteristics Analysis of Different Resident Patients with Hyperthyroidism

作　　者：路琼 王全胜 李骏 LU Qiong;WANG Quan-sheng;LI Jun(Department of Endocrinology, BenQ Medical Center, the Affilicated BenQ Hospital of Nanjing Medical University, Nanjing 210019, China)

机构地区：[1]南京明基医院内分泌科,南京医科大学附属明基医院,江苏南京210019

出　　处：《药物生物技术》2018年第2期149-152,共4页Pharmaceutical Biotechnology

摘　　要：探讨该院不同类型甲状腺功能亢进症(Hyperthyroidism)住院患者的临床特点,根据病因将甲状腺功能亢进症患者分为亚急性甲状腺炎组、桥本假性甲亢组、弥漫性毒性甲状腺肿(GD)及桥本甲亢组,测定甲状腺功能亢进症患者的甲状腺功能及其相关抗体,并进行甲状腺超声检查,探讨不同分组甲亢的临床特征。3组甲亢患者中,女性比例均明显高于男性;GD及桥本甲亢组的发病年龄要低于亚急性甲状腺炎组和桥本假性甲亢组(P<0.05);GD及桥本甲亢组的甲亢程度要高于亚急性甲状腺炎组和桥本假性甲亢组(P<0.05);GD及桥本甲亢是患者因甲亢而住院的最主要的疾病,而因桥本假性甲亢住院的比例最低。TGAb和TPOAb在亚急性甲状腺组、桥本假性甲亢组、GD及桥本甲亢组中呈现依次递增(P<0.05);TRAb在GD及桥本甲亢组显著高于其他两组(P<0.01),而在亚急性甲状腺炎组和桥本假性甲亢组之间没有差距(P>0.05)。亚急性甲状腺炎的超声特征为片状低回声区,边界不清晰,形态不规则;桥本假性甲亢的超声特征为腺实质回声分布欠均匀,甲状腺内血流分布稍增多,少数彩超提示未见异常;GD及桥本甲亢的超声特征为腺实质体积增大,回声不均、增粗,甲状腺内血流信号丰富或极丰富,但血流信号增多的比例随着TPOAb的显著增高而明显降低。住院患者亚急性甲状腺炎、桥本假性甲亢、GD及桥本甲亢在性别、发病年龄、构成比、甲亢程度、自身抗体及超声图像改变等方面均有不同的特点,对临床诊断和治疗有一定指导意义。To explore the clinical characteristics of different resident patients with hyperthyroidism, according the pathogeny, the patients with hyperthyroidism were divided into three groups：subacute thyroiditis group,Hashimoto pseudo hyperthyroidism group and GD or Hashimoto hyperthyroidism group. The author examine the thyroid function and related autoantibody of the patients with hyperthyroid-ism, and make the thyroid ultrasound examination, to explore the clinical characteristics of different resident patients with hyperthyroid-ism. Among the three hyperthyroidism groups, the proportion of females was higher than that of the males obviously. The age of onset of GD or Hashimoto hyperthyroidism group was lower than that of the other two groups (P 〈 0.05). The hyperthyroidism degree of GD or Hashimoto hyperthyroidism group was higher than that of the other two groups (P 〈 0.05) ; GD or Hashimoto hyperthyroidism was the most disease among the resident patients with hyperthyroidism, Hashimoto pseudo hyperthyroidism was the least. TGAb and TPOAb successively increased among the subacute thyroiditis group, Hashimoto pseudo hyperthyroidism group and GD or Hashimoto hyperthyroidism group （P 〈 0.05). The TRAb of GD or Hashimoto hyperthyroidism group was higher than the other two groups (P 〈 0. 01). The TRAb of subacute thyroiditis or Hashimoto pseudo hyperthyroidism group has no obvious difference. The ultrasonic feature of subacute thyroiditis was patchy hypoechoic region, the boundary was not clear and the shape was not irregular. The ultrasonic feature of Hashimoto pseudo hyperthyroidism was uneven distribution, the distribution of blood flow in the thyroid gland increased slightly, and few patients were normal for the ultrasound. The ultrasonic feature of GD or Hashimoto hyperthyroidism was the increase of thyroid volume, uneven or thickening distribution, rich or very rich blood flow in the thyroid gland, and the ratio of the rich blood flow decreased obviousy with the increase of the TPOAb. There were differe

关 键 词：甲状腺功能亢进症 临床特征 亚急性甲状腺炎 桥本氏甲状腺炎 弥漫性毒性甲状腺肿 桥本甲亢 

分 类 号：R585.1[医药卫生—内分泌]