甲状腺功能障碍症:一个回顾
Sun Y Lee1, Elizabeth N Pearce1
1Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
JAMA
|October 17, 2023
概括
甲状腺功能障碍,影响2.5%的成年人,可以导致严重的健康问题,如心脏病和骨质疏松症. 早期诊断和个性化治疗,包括抗甲状腺药物,手术或放射性,对于管理这种情况至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 过度甲状腺功能障碍 (甲状腺激素低,T3 / FT4高) 影响全球0.2-1.4%的人.
- 亚临床甲状腺功能障碍 (甲状腺激素低,T3 / FT4正常) 影响全球0.7-1.4%的人.
- 没有治疗的甲状腺功能障碍会增加死亡风险,并可能导致心律失常,心力衰竭和骨质疏松症.
研究的目的:
- 审查甲状腺功能障碍的患病率,原因,症状和治疗.
- 突出个性化以患者为中心的治疗方法的重要性.
主要方法:
- 对诊断的临床表现,甲状腺功能测试和甲状腺蛋白受体抗体状态的审查.
- 考虑甲状腺扫描检查不清楚病因或结节的存在.
- 评估治疗选择,包括抗甲状腺药物,放射性切除和手术.
主要成果:
- 格雷夫斯病是最常见的病因 (女性为2%,男性为0.5%).
- 症状包括焦虑,失眠,心跳和体重减轻; 格雷夫斯病可能伴有或外.
- 毒性结节可以引起压缩症状;甲状腺炎可以支持性地管理.
结论:
- 甲状腺功能障碍影响全球2.5%的成年人,与骨质疏松症,心脏病和死亡率有关.
- 第一线治疗包括抗甲状腺药物,手术和放射性.
- 个性化,以患者为中心的治疗对于最佳结果至关重要.
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