精准分层、合理干预:从《中国老年人甲状腺疾病诊疗专家共识(2021)》探讨老年亚临床甲减的合理诊治  

Consensus and controversies of the diagnosis and treatment of subclinical hypothyroidism in the elderly

作　　者：孙宇 王艳 徐书杭[3] 刘超[3] Sun Yu;Wang Yan;Xu Shuhang;Liu Chao(Department of Endocrinology and Metabolism,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,China;Department of Geriatrics,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,China;Department of Endocrinology and Metabolism,Affiliated Hospital of Integration Traditional Chinese and Western Medicine Nanjing University of Chinese Medicine,Nanjing 210028,China)

机构地区：[1]徐州医科大学附属宿迁医院内分泌科,宿迁223800 [2]徐州医科大学附属宿迁医院老年医学科,宿迁223800 [3]南京中医药大学附属中西医结合医院(江苏省中西医结合医院)内分泌科,南京210028

出　　处：《国际内分泌代谢杂志》2023年第6期521-524,共4页International Journal of Endocrinology and Metabolism

基　　金：2020年江苏省重点研发计划(BE2020726);2021年江苏省老年健康科研项目(LK2021059)。

摘　　要：亚临床甲状腺功能减退症(SCH)是老年人常见疾病之一。促甲状腺激素(TSH)的正常切点受年龄、碘营养状况等多种因素影响,显著影响了老年SCH的诊断和治疗。心血管疾病是老年SCH的主要终点事件,应根据TSH水平、年龄和心血管疾病及其危险因素指导老年SCH的干预。对于老年SCH患者是否需要进行左甲状腺素替代治疗,尤其是TSH在10~20 mU/L的这部分群体,替代治疗能否获益,尚需前瞻性的干预研究进行证实。Subclinical hypothyroidism(SCH)is one of the common diseases in the elderly.The normal cut-off point for thyroid stimulating hormone(TSH)is influenced by a variety of factors,including age and iodine nutritional status,which significantly affects the diagnosis and treatment of SCH in the elderly.Cardiovascular disease is the major endpoint event of SCH in the elderly,and interventions for SCH in the elderly should be guided by TSH levels,age,and cardiovascular disease and its risk factors.Prospective intervention studies are needed to confirm the need for levothyroxin replacement therapy in elderly SCH patients,especially in this group with TSH in the range of 10-20 mU/L,and whether replacement therapy can be beneficial.

关 键 词：老年人 亚临床功能减退症 心血管疾病 甲状腺激素替代治疗 

分 类 号：R581.2[医药卫生—内分泌]