亚临床甲状腺功能低下症:一篇综述
Bernadette Biondi1, Anne R Cappola2,3, David S Cooper4
1Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
JAMA
|July 10, 2019
概括
甲状腺功能低下症的特征是甲状腺刺激激素 (TSH) 的升高与正常的自由甲状腺素是常见的. 大多数病例不需要治疗,但TSH水平为10mU/L或更高或症状较轻的个体可能需要干预.
科学领域:
- 内分泌学
- 内部医学
- 老年病学
背景情况:
- 亚临床甲状腺功能低下 (提升的TSH,正常的FT4) 影响高达10%的成年人.
- 老龄化会增加TSH,可能导致老年人过度诊断.
- 相关风险包括心血管事件和认知障碍.
研究的目的:
- 审查临床下甲状腺症的定义,患病率和治疗方法.
- 讨论莱沃甲状腺素治疗的风险和益处.
- 提供治疗指示的指导.
主要方法:
- 临床下甲状腺症研究的文献综述
- 在老年人群中分析TSH水平.
- 对治疗结果和风险的评估.
主要成果:
- 随着年龄的增长,TSH水平自然上升,使老年人的诊断复杂化.
- 患有甲状腺过氧化酶抗体的人更有可能发展为明显的甲状腺功能低下.
- 在65岁以上的患者中,Levothyroxine治疗缺乏已证实的益处,并带有风险.
结论:
- 大多数亚临床甲状腺功能低下病例可以通过观察来治疗.
- 对于TSH≥10mU/ L或症状较年轻/ 中年患者进行治疗.
- 对于治疗决定来说,要仔细考虑年龄和症状.
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