《内分泌系统疾病》11、甲状腺疾病-教学课件（非AI生成）.ppt

Malignanttumorsderivedfromparafollicularcells滤泡旁细胞恶性肿瘤APUDtumor,secretecalcitoninandotherhormones(ACTH/CEA).多中心通常为家族性。*Pathologicchanges*存在可与TSH受体结合的抗体具有类似TSH的作用，可刺激滤泡上皮增生和甲状腺素分泌过多。EtiologyandpathogenesisHLA特定单倍群易感，HLA-B8和-DR3抑制性T细胞受体基因位点和酪氨酸磷酸酶位点多态性患者家族中其他成员患病率也高，同卵双胞胎6耦合率60%。TSH抗体、过氧化物酶抗体、甲状腺球蛋白抗体甲状腺刺激免疫球蛋白抗体对此病相对特异。*碘剂（复方碘溶液，Lugol溶液）准备原理：大量碘剂能抑制蛋白水解酶，使甲状腺素不能与蛋白水解酶解离。碘剂的作用：稳定功能亢进的滤泡壁细胞；减少甲状腺的血液循环，使腺体内充血减少，甲状腺变小、变硬。服碘注意事项：服碘剂2-3周后，患者甲亢症状好转，但碘剂只能抑制甲状腺激素的释放，而不能抑制其合成，用碘剂后甲状腺内激素的储量增多，一旦停用碘剂，储存在甲状腺滤泡内甲状腺球蛋白大量分解，甲亢症状又重复出现，且加重。故凡不准备施行手术治疗的病人，一律不要服用碘剂。甲亢症状控制到什么程度才可以手术?服碘2-3周后，患者情绪稳定，睡眠好转，体重增加，脉搏稳定在每分钟90次以下，甲状腺变小、变硬，基础代谢率接近正常，即应实行手术。如果错过这个时间，即是继续服碘，甲亢症状又会重现，甚至加重。***Theterm?cretin?describesapersonsoaffected,but,aswithwordssuchas?spastic,and?lunatic,hasbecomeawordofabuse.?Cretin?becameamedicalterminthe18thcentury,froman?Occitan?andan?Alpine?French?expression,prevalentinaregionwherepersonswithsuchaconditionwereespeciallycommon(seebelow);itsawwidemedicaluseinthe19thandearly20thcenturies,andwasactuallyatickboxcategoryonVictorian-eracensusformsintheUK.ThetermspreadmorewidelyinpopularEnglishasamarkedlyderogatorytermforapersonwhobehavesstupidly.Becauseofitspejorativeconnotationsinpopularspeech,health-careworkershavemostlyabandoned?cretin.[citationneeded]Theetymologyof?cretin?isuncertain.Severalhypothesesexist.ThemostcommonderivationprovidedinEnglishdictionariesisfromtheAlpineFrenchdialectpronunciationoftheword?Chrétien?((a)?Christian),whichwasagreetingthere.Accordingtothe?OxfordEnglishDictionary,thetranslationoftheFrenchtermintohumancreatureimpliesthatthelabelChristianisareminderofthehumanityoftheafflicted,incontrasttobrutebeasts.[1]?Othersourcessuggestthat?Christian?describesthepersonsChrist-likeinabilitytosin,stemming,insuchcases,fromanincapacitytodisting