新型冠状病毒感染与亚急性甲状腺炎发生相关病例回顾分析  

A review of cases related to novel coronavirus infection and subacute thyroiditis

作　　者：邢渊 孙小红 窦国清 XING Yuan;SUN Xiao-hong;DOU Guo-qing(The People's Hospital of Qinzhou,Tianshui;Tianshui Hospital of Integrated Chinese and Western Medicine,Tiangshui,Gansu 740020)

机构地区：[1]天水市秦州区人民医院 [2]天水市中西医结合医院,甘肃天水740020

出　　处：《赣南医学院学报》2024年第7期684-690,共7页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:对新型冠状病毒感染后发生的亚急性甲状腺炎个案进行荟萃回顾分析。方法:检索2019年11月至2022年12月在PubMed、EMBASE、Cochrane Library和中国知网上发表的与新型冠状病毒感染后亚急性甲状腺炎发生相关病例报道,记录作者、国家、性别、临床症状、核酸检测、发病时间、甲状腺功能和相应的炎症指标、甲状腺超声、甲状腺摄碘率或者核素扫描情况、治疗用药和甲状腺功能复查情况的完整资料,分类列表比较。结果:个案的共有特点是新型冠状病毒感染后出现发热,颈部疼痛,促甲状腺激素水平偏低,FT4和FT3水平偏高,炎症指标血沉和C反应蛋白明显偏高或正常,甲状腺球蛋白抗体和过氧化物酶抗体均阴性,非甾体类和糖皮质激素治疗4~8周后甲状腺功能恢复正常,症状消退。结论:新型冠状病毒感染后患者会出现亚急性甲状腺炎的发生,主要是通过病毒和甲状腺内ACE2受体亲和性结合受体反应、垂体轴反馈途径实现的。治疗方面以糖皮质激素为主,提醒临床医生重视新型冠状病毒感染后的亚急性甲状腺炎。Objective:To conduct a meta-review of cases of subacute thyroiditis after novel coronavirus infection.Methods:A search was donefor case reports related to subacute thyroiditis after novel coronavirus infection published in PubMed,EMBASE,Cochrane Library and CNKI from November 2019 to December 2022.Complete data of author,coun‐try,gender,clinical symptoms,nucleic acid detection,onset time,thyroid function and corresponding inflammatory indi‐cators,thyroid ultrasound,thyroid iodine uptake rate or nuclide scanning,therapeutic drugs and thyroid function review were recorded,classified and listed for comparison.Results:Common features of the cases were fever,neck pain,low thyrotropin(TSH)levels,high FT4 and FT3 levels,and significantly elevated or normal inflammatory markers ESR and C-reactive protein(CRP).Thyroglobulin antibody(TGAb)and peroxidase antibody(TPO-Ab)were negative.Thyroid function returned to normal and symptoms resolved after 4 to 8 weeks of nonsteroidal and glucocorticoid therapy.Conclu-sion:After novel coronavirus infection,patients will develop subacute thyroiditis,which is mainly achieved through the affinity binding receptor reaction between the virus and the thyroid ACE2 receptor and the pituitary axis feedback path‐way.The treatment is mainly based on glucocorticoids,reminding clinicians to pay attention to subthyroiditis after novel coronavirus infection.

关 键 词：新型冠状病毒感染 亚急性甲状腺炎 糖皮质激素 预后 

分 类 号：R581.4[医药卫生—内分泌]