老年甲状腺功能减退症的管理  

Management of hypothyroidism in older people.

作　　者：倪佳佳 龙钰 张海清[1] NI Jia-jia;LONG Yu;ZHANG Hai-qing(Department of Endocrinology,Shandong Provincial Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250021,China)

机构地区：[1]山东大学附属省立医院内分泌科,山东济南250021

出　　处：《中国实用内科杂志》2021年第2期96-99,共4页Chinese Journal of Practical Internal Medicine

摘　　要：老年人的下丘脑-垂体-甲状腺轴功能下降。老年甲状腺功能减退症(甲减)患病率高,在诊断和治疗方面存在诸多的争议,是目前的研究热点。老年甲减的临床表现不典型,往往合并多种疾病。亚临床甲状腺功能减退对老年人心血管、认知、生活质量和寿命的影响和左旋甲状腺素片(L-T4)替代治疗获益不确定。年龄特异性促甲状腺激素(TSH)参考值尚未确定,老年甲减患者的过度诊断和过度治疗的风险高。临床甲减和亚临床甲减的治疗时机不同。对待老年甲减患者,临床医生需要综合评估,谨慎对待,制定个体化治疗方案。The function of hypothalamus-pituitary-thyroid axis declines in the older people.The prevalence of hypothyroidism in the elderly population is high,and the diagnosis and treatment of hypothyroidism are controversial,which is the current research hotspot.Clinical manifestations of hypothyroidism in the elderly are not typical and often are associated with a variety of diseases.The effects of subclinical hypothyroidism on cardiovascular function,cognition,quality of life,and longevity in the elderly as well as the benefits of L-T4 replacement therapy are uncertain.Age-specific TSH reference values have not been determined,and the risk of overdiagnosis and overtreatment in elderly patients with hypothyroidism is high.The treatment timing of clinical hypothyroidism and subclinical hypothyroidism is different.Clinicians need to make comprehensive assessment,careful treatment and individualized treatment plan in dealing with elderly patients with hypothyroidism.

关 键 词：甲状腺功能减退症 老年 诊断 治疗 

分 类 号：R581[医药卫生—内分泌]