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目的 探讨散发型无痛性甲状腺炎 (SPT)在甲亢中的发病率、临床表现、实验室检查特征及不同治疗方法对其预后的影响。方法 从临床表现为甲亢的 2 76例患者中 ,诊断出 4 3例SPT ,随机分为治疗组 2 2例 ,对照组 2 1例 ,进行临床研究。结果 SPT的发病率为 15 5 8% ,其相关的实验室检查不同于Graves病、毒性甲状腺腺瘤 (Plummer病 )及桥本病 (Hashimoto病 ) ;治疗组 :甲状腺毒症期 (37 2 3± 4 2 8)d ,正常甲状腺血症期 (16 4 3±3 4 2 )d ;低甲状腺毒症期 (18 6 5± 6 31)d ,复发率 4 5 4% (1/2 2 )无永久性甲低发生 ;对照组 :甲状腺毒症期 (6 8 35± 8 2 3)d ,正常甲状腺血症期 (31 4 5± 7 2 3)d ;低甲状腺毒症期 (10 2 4 2± 2 1 34)d ,复发率 14 2 8% (3/2 1) ,永久性甲低发生率 9 5 2 % (2 /2 1)。结论 甲亢中 ,SPT仅次于Graves病而较Plummer病及Hashimoto病多发 ,实验室检查对鉴别诊断意义大 ,相关治疗可较快控制甲亢症状、降低复发率及减少永久性甲低发生
Objective To investigate the incidence of thyroiditis (SPT) in hyperthyroidism, clinical manifestations, laboratory features and different treatment methods on the prognosis. Methods Totally 43 cases of SPT were diagnosed in 2 76 patients with hyperthyroidism, and were randomly divided into treatment group (n = 22) and control group (n = 21). The clinical study was performed. Results The incidence of SPT was 15 58%. The related laboratory tests were different from Graves’ disease, Plummer’s disease and Hashimoto’s disease. The treatment group: Thyrotoxicosis (37 2 3 ± 4 2 8) d, the duration of normal thyroid hyperlipidemia was (16 4 3 ± 3 4 2) days, the duration of hypo thyrotoxicosis was 18 6 5 ± 6 31 days, the recurrence rate was 45.4% (1/2 2) There was no permanent hypothyroidism in the control group. The control group had a significant reduction in the duration of thyrotoxicosis (6 8 35 ± 8 2 3 days), normal thyroid hyperplasia (31 4 5 ± 7 2 3) days, and low thyrotoxicosis 2 ± 2 1 34) d, the recurrence rate was 14 2 8% (3/2 1), and the permanent hypothyroidism rate was 95 2% (2/2 1). Conclusions In hyperthyroidism, SPT is second only to Graves’ disease and more frequent than Plummer’s disease and Hashimoto’s disease. Laboratory tests are of great significance to the differential diagnosis, and the related treatment can control the symptoms of hyperthyroidism rapidly, reduce the relapse rate and reduce the incidence of permanent hypothyroidism