甲状腺功能与慢性疾病的管理.PDFVIP

Hainan Med J, Dec. 2013, Vol. 24, No. 24 海南医学2013年12月第24卷第24期 doi:10.3969/j.issn.1003-6350.2013.24.1522 ·综 述· 甲状腺功能与慢性疾病的管理 许晋川，高 照 (海南省人民医院医疗保健中心，海南 海口 570311) 【摘要】 老年慢性疾病人群中普遍存在甲状腺功能异常，表现为临床和亚临床甲状腺功能异常、正常甲状 腺性病态综合征。其对糖、脂、蛋白代谢及心血管系统的影响，使得常见老年慢性疾病(如糖尿病、心血管疾病) 的 管理变得复杂和困难。根据目前循证证据及专家建议，早期识别甲功异常的易感人群，积极进行筛查和监测，对 高危异常患者进行早期合理干预，将有助于慢性疾病的有效管理及生活质量的提升。 【关键词】 甲状腺功能异常；糖尿病；心血管疾病；亚临床甲减/亢；老年 【中图分类号】R581 【文献标识码】A 【文章编号】 1003—6350（2013 ）24—3673—04 Managementofthyroidfunctionandchronicdiseases. XUJin-chuan,GAOZhao.MedicalCareCenter,Peoples HospitalofHainanProvince,Haikou570311,Hainan,CHINA 【Abstract】Thyroid dysfunction is quite common among elderly patients with chronic diseases, which can be mani- fested as clinical/subclinical hyper/hypo-thyroidism and euthyroid sick syndrome. Its influences on three major material metabolisms of glucose, lipid and protein, plus the cardiovascular system, make the management of some common chronic diseases, such as diabetes mellitus and miscellaneous cardiovascular diseases, in the elderly people more complex and diffi- cult. Based on current evidence and suggestions from experts, the modality to early recognize susceptible population of thy- roid dysfunction for constant screening and monitoring, and take early and reasonable treatment for patients of high risks, may contribute to more efficient management of chronic diseases and thus, the improvement of life quality. 【Keywords】Thyroid dysfunction; Diabetes mellitus; Cardiovascular diseases; Subclinical hypo/hyper-thyroidism; Elderly 甲状腺激素影响到机体正常功能的方方面面，随 女性患病率至少为2% ，男性至少为0.2% [1] 。美国的 着检测技术的改进、人口的老龄化及各种影响甲状腺 NHANES III 调查显示甲亢患病率为 1.3% ( 临床 功能药物/