探讨散发型无痛性甲状腺炎的临床表现及分析.docxVIP

探讨散发型无痛性甲状腺炎(SPT)的临床表现及分析 刘利红凌丽栾增强 内江市中医医院内分泌科四川内江641000 【摘要】目的：通过对散发型无痛性甲状腺炎(SPT)的临床表现进行分析， 防止其和Graves病的诊断出现混淆。方法：对200例均经过FT4、FT3、TSH、TSH 受体的抗体(TRAb)、彩色多普勒超声、甲状腺摄碘率(RAIU)、部分甲状腺细针 穿刺活检(FNAB)、等检查确诊了的SPT病例进行分析。结果：在甲状腺的毒症 期中其临床的表现和Graves病症状相似；全部200例患者中FT4与FT3的数值 均高于正常范围，超敏的TSH数值在正常范围以下；诱因中以上呼吸道感染为最 多见，有56例，占28%； 150例患者在TRAb检查内有141例患者的检测结果显 示为正常，9例患者的检测结果显示为低水平的升高；103例进行彩色多普勒检 查的患者中，其表现均为甲状腺肿血流的流量没有明显的增加，甲状腺肿上动脉 最高的流速在70cm/s以内；在RAIU检查中170例患者的检测数值在正常范围之 下，30例患者的检测数值在正常范围之间；90例患者在部分甲状腺的FNAB检 查中，有69例的病例表现符合无痛性的甲状腺炎症。结论：由于散发型无痛性 甲状腺炎的患者其临床表现较多变且复杂，体征与症状并不典型，所以在诊断过 程中容易产牛误诊或漏诊等现象，所以在诊断过程中应以实验室的检查为依据, 强化对此类病症的认识，从而提升此类病症的诊治水准。 【关键词】散发型无痛性甲状腺炎;临床表现;分析To investigate the sporadic type painless thyroiditis(SPT)clinical manifestations and analysis Liu LihongLing LiLuan Zengqiang [Abstract 1 Objective :To elucidate the identification of the sporadic type pain less thyroiditis(SPT)and Graves disease through an analysis of the clinical manifestation. Method： 200 cases of SPT from 2008 to 2012 were analyzed with retrospective investigation ,FT3, FT4, TSH, TSH receptor antibody(TRAb), color Doppler, radioactive iodine uptake(RAIU)and Fine needle aspiration biopsy(FNAB)were performed in some patients. Results： Clinical feature of SPT Was similar with Graves disease in thyrotoxic phase. The major precipitati ng factor was upper respiratory infect i on .The concen trati ons of serum FT3 and FT4 were in creased while serum TSH was decreased in all patients. The concentrations of TRAb were normal in 141 of 150 patien ts and were high at low level in 9 patients.Blood flow in thyroid was kept almost normal, STA Vmax does not exceed 70cm / s in 103 patients. RAIU was decreased in 170 patients and kept normal in remains. The results of FNAB were accorded with the feature of SPT in 141 of 150 patients.Conclusion:Because the clin ical manifestati ons of the sporadic type of pain less thyroiditis were versatile and complex, the signs and symptoms are not typical, so is easily leads to misdiagnosi