亚临床甲状腺功能亢进症的诊治

doi:10.3969/j.issn.1004-583X.2016.03.002

临床荟萃 ›› 2016, Vol. 31 ›› Issue (3): 237-240.doi: 10.3969/j.issn.1004-583X.2016.03.002

亚临床甲状腺功能亢进症的诊治

张力辉,袁玲玲

河北医科大学第二医院内分泌科,河北石家庄 050000

收稿日期:2015-11-12 出版日期:2016-03-05 发布日期:2016-04-18
通讯作者: 张力辉,Email: zhanglihui10510@163.com
作者简介:张力辉，河北医科大学第二医院大内科副主任，内分泌科主任，主任医师，教授。现任中华医学会内分泌分会委员，中国微循环学会糖尿病与微循环分会委员，河北省医学会内分泌分会主任委员，糖尿病学分会候任主任委员。中华糖尿病杂志通讯编辑。

Progress in diagnosis and treatment of subclinical hyperthyroidism

Zhang Lihui, Yuan Lingling

Department of Endocrinology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

Received:2015-11-12 Online:2016-03-05 Published:2016-04-18
Contact: Zhang Lihui, Email: zhanglihui10510@163.com

摘要/Abstract

摘要： 亚临床甲状腺功能亢进症(subclinical hyperthyroidism, SH)是一种特殊类型的甲状腺功能亢进症(甲亢),是指血清促甲状腺激素(thyroid stimulating hormone, TSH)水平低于正常参考值下限,而总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、游离T3、游离T4在正常值范围,伴或不伴有轻微的甲亢症状。随着TSH测定方法的改进,SH的检出率明显升高。大多数SH患者可不经治疗自行缓解,但仍有部分患者进展为临床甲亢,并出现严重的并发症,如对心血管系统的负面影响,加重骨质疏松和促进骨折发生、老年性痴呆等。因此正确处理SH具有重要的临床意义。

关键词: 甲状腺功能亢进症, 促甲状腺素, 治疗

Abstract: Subclinical hyperthyroidism (SH) is diagnosed in patients having a persistently low or undetectable serum concentration of thyroid-stimulating hormone (TSH) with normal total triiodothyronine, total thyroxine, free triiodothyronine and free thyroxine concentrations, with or without minor symptoms of hyperthyroidism. With the development of the determination method of TSH, the detection rate of SH was increased significantly. Most of the patients with SH can be spontaneous remission without treatment, but there are still some patients to have progress for clinical hyperthyroidism. SH is associated with some serious complications, such as the negative effects on cardiovascular system, osteoporosis, fratures, senile dementia, and so on. It has an important clinical significance to treat SH precisely.

Key words: hyperthyroidism, thyrotropin, therapy

中图分类号:

R581.1

张力辉,袁玲玲. 亚临床甲状腺功能亢进症的诊治[J]. 临床荟萃, 2016, 31(3): 237-240.

Zhang Lihui, Yuan Lingling. Progress in diagnosis and treatment of subclinical hyperthyroidism[J]. Clinical Focus, 2016, 31(3): 237-240.

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https://huicui.hebmu.edu.cn/CN/Y2016/V31/I3/237

参考文献

[1] Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management [J]. JAMA, 2004, 291(2): 228-238.
[2] Biondi B, Palmieri EA, Klain M, et al. Subclinical hyperthyroidism: clinical features and treatment options [J]. Eur J Endocrinol, 2005, 152(1): 1-9.
[3] Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction[J]. Endocr Rev, 2008, 29(1): 76-131.
[4] 葛均波, 徐永健. 内科学[M]. 8版. 北京: 人民卫生出版社, 2013:688.
[5] Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists[J]. Thyroid, 2011, 21(6): 593-642.
[6] Cooper DS, Biondi B. Subclinical thyroid disease[J]. Lancet,2012, 379(9821): 1142-1154.
[7] Mitchell AL, Pearce SH. How should we treat patients with low serum thyrotropin concentrations? [J]. Clin Endocrinol (Oxf), 2010, 72(3): 292-296.
[8] Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum [J]. Thyroid, 2011, 21(10): 1081-1125.
[9] 中华医学会内分泌分会, 中华医学会围产医学分会. 妊娠和产后甲状腺疾病诊治指南[J]. 中华内分泌代谢杂志, 2012, 28(5): 354-444.
[10] De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline [J]. J Clin Endocrinol Metab, 2012, 97(8): 2543-2565.
[11] Nathan N, Sullivan SD. Thyroid disorders during pregnancy [J]. Endocrinol Metab Clin North Am, 2014, 43(2): 573-579.
[12] 李智, 李静, 滕卫平. 115例亚临床甲状腺功能亢进症的流行病学研究[J].中华内分泌代谢杂志, 2003, 19(2):99-100.
[13] Biondi B, Bartalena L, Cooper DS,et al. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism [J]. Eur Thyroid J, 2015, 4(3): 149-163.
[14] Wirth CD, Blum MR, da Costa BR, et al.Subclinical thyroid dysfunction and the risk for fractures: a systematic review and meta-analysis [J].Ann Intern Med, 2014, 161(3): 189-199.
[15] Moon JH, Park YJ, Kim TH, et al. Lower-butnormal serum TSH level is associated with the development or progression of cognitive impairment including mild cognitive impairment and dementia in elderly: Korean Longitudinal Study on Health and Aging (KLoSHA) [J]. J Clin Endocrinol Metab, 2014,99(2): 424-432.
[16] Wiersinga WM. Guidance in subclinical hyperthyroidism and subclinical hypothyroidism: are we making progress?[J]. Eur Thyroid J, 2015, 4(3):143-148.
[17] 杜馥曼, 杨玉芝, 王嵬民,等. 小剂量甲巯咪唑治疗亚临床甲状腺功能亢进症合并阵发性房颤的临床观察[J]. 中华内分泌代谢杂志, 2011, 27(5): 420-421.
[18] 孙权. 丙基硫氧嘧啶、普萘洛尔联合用药治疗亚临床甲亢合并阵发性房颤的疗效分析[J]. 中国医药指南, 2015, 13(5):181-182.
[19] Mark PD, Andreassen M, Petersen CL, et al. Treatment of subclinical hyperthyroidism: effect on left ventricular mass and function of the heart using magnetic resonance imaging technique[J]. Endocr Connect, 2015, 4(1):37-42.
[20] Azizi F, Amouzegar A, Mehran L,et al. Management of hyperthyroidism during pregnancy in Asia[J]. Endocr J, 2014, 61(8): 751-758.

亚临床甲状腺功能亢进症的诊治

Progress in diagnosis and treatment of subclinical hyperthyroidism

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