亚临床甲状腺功能障碍的自然过程 在荷兰的初级保健中
Stan R Ursem1,2,3, Wendy Pj den Elzen2,4,5, Jesse M van den Berg3,5,6
11Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, Location University of Amsterdam and Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
European thyroid journal
|November 6, 2025
概括
亚临床甲状腺功能障碍症 (SHT) 影响每10万人年中有200人. 较低的TSH和女性性别增加了进展风险,表明需要在初级保健中更好地遵守指南.
科学领域:
- 内分泌学 在内分泌学.
- 主要护理医学 医疗保健
- 流行病学 流行病学
背景情况:
- 亚临床甲状腺功能障碍症 (SHT) 由血清甲状腺刺激激素 (TSH) 和正常的自由甲状腺素 (FT4) 的低水平来定义.
- 在初级保健中,SHT的流行病学和自然过程尚不清楚.
- 需要进一步调查的SHT对健康的潜在影响.
研究的目的:
- 为了确定在初级保健机构中SHT的发病率和自然过程.
- 评估是否遵守荷兰初级保健指南,用于SHT后续治疗.
- 确定影响SHT进展,恢复和持续性的因素.
主要方法:
- 使用荷兰全科医生 (GP) 数据 (2012-2021) 的回顾性队列研究.
- 对11163名生物化学确认的SHT患者的分析.
- 评估进展到明显的甲状腺功能障碍,恢复,坚持和遵守指南的进展情况.
主要成果:
- 每年的SHT发病率约为每10万人/年200人.
- 在5年的中位数中,47%的SHT患者康复了,11%的患者持续了,8%的患者进展到明显的甲状腺功能障碍.
- 较低的基线TSH (<0.1 mU/L) 和女性与减少恢复和增加进展几率有关.
结论:
- 在亚临床甲状腺功能障碍症患者中,很少有一小部分患者进展到明显的甲状腺功能障碍症.
- 较低的TSH水平和女性性别是进展的危险因素.
- 目前在初级保健中对SHT随访的遵守指南是不理想的,需要改进.
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