甲状腺機能障害
Layal Chaker1, David S Cooper2, John P Walsh3
1Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
Lancet (London, England)
|January 26, 2024
まとめ
甲状腺毒性症 または 甲状腺 活動 過剰 は,様々 な 症状 を もたらす. 診断には 甲状腺ホルモンのレベルと 抗体検査が含まれており 薬,放射性ヨウ素,手術などの治療法があります
科学分野:
- 内分泌学
- 内科 医学
背景:
- 甲状腺毒性症には,甲状腺機能低下 (甲状腺ホルモンの過剰合成) と甲状腺炎 (甲状腺炎) が含まれる.
- 常見の原因には,甲状腺症に対するグラブス病と毒性結節性,甲状腺炎に対する自己免疫的またはウイルス性要因が含まれます.
研究 の 目的:
- 甲状腺毒性症の診断方法と治療戦略を概説する.
- 甲状腺症と甲状腺炎を,臨床表現と診断マーカーに基づいて区別する.
主な方法:
- 診断は,抑制された甲状腺刺激ホルモン (TSH) レベルと増加したフリーチロキシンとトライヨドチロニンに依存します.
- さらに評価は,臨床評価,TSH受容体抗体の検出,および放射性核素甲状腺シンチグラフィを含む.
- 治療方法には,甲状腺炎に対する抗甲状腺薬,放射性ヨウ素,甲状腺切除術,甲状腺炎に対する症状治療またはグルココルチコイド治療が含まれます.
主要な成果:
- 甲状腺機能過剰症は甲状腺ホルモンのレベルが上昇し,亜臨床的甲状腺機能過剰症は,抑制されたTSHにもかかわらず正常なレベルを示します.
- グレイブス 病 は しばしば 抗甲状腺 薬 で 治療 さ れ ます が,有毒 な 結節 や は 放射性 ヨウ素 や 手術 を 好む か も しれ ませ ん.
- 長期の抗甲状腺薬療法は,グレイヴス病と毒性結節性で支持されています.
結論:
- 甲状腺毒性の正確な診断には,TSH,甲状腺ホルモン,および特定の抗体を評価する必要があります.
- 治療の選択は,根本的な原因,患者因子,および疾患の重症度によって異なります.
- 甲状腺症と甲状腺炎の両方に有効な管理戦略があり,患者のアウトカムを改善します.
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