小结
定义
病史和体格检查
关键诊断因素
- 颈疼痛
- 触痛，坚实，肿大的甲状腺
- 发热
- 心悸
其他诊断因素
- 近期病毒性感染
- 肌痛
- 不适感
- 震颤
- 怕热
危险因素
- 病毒感染
- 某些 HLA 和 B35 等位基因
诊断性检查
首要检查
- 血清促甲状腺激素 (TSH)
- 血清总 T4、总 T3、游离 T3、游离 T4 指数和游离 T4
- T3：T4比值
- 放射性碘摄取
- 血沉
- 血清 CRP
- 血清甲状腺抗体（甲状腺过氧化物酶抗体 [TPO Ab]）
需考虑的检查
- 细针抽吸活检
- 全血细胞计数
新兴检查
- 甲状腺超声扫描
治疗流程
甲状腺功能亢进（甲状腺毒症）期
甲减阶段
撰稿人
作者
Angela M. Leung, MD, MSc
Associate Professor of Medicine
UCLA David Geffen School of Medicine
VA Greater Los Angeles Healthcare System
Los Angeles
CA
利益声明
AL has served on the board of directors of the American Thyroid Association. She is editor-in-chief of Clinical Thyroidology, a journal of the American Thyroid Association. AL is a speaker for Medical Education Resources and MCE Conferences. She has consulted for Vertice Pharma and received article process charges paid by IBSA Institut Biochimique for an invited review article. AL has lectured at a conference sponsored by Merck and presented educational content for the Endocrine Society and the American Association of Clinical Endocrinology. AL is an advisor to Medscape and has received research funding from the U.S. Dept of Veterans Affairs.
鸣谢
Dr Angela M. Leung would like to gratefully acknowledge Dr Stephanie L. Lee, the previous contributor to this topic.
利益声明
SLL declares that she has no competing interests.
同行评议者
Georg Hennemann, MD
Professor of Medicine and Endocrinology
Medical Center Spijkenisse
The Hague
The Netherlands
利益声明
Not disclosed.
Ronald Merrell, MD
Professor of Surgery
Virginia Commonwealth University
Richmond
VA
利益声明
RM declares that he has no competing interests.
鉴别诊断
- Graves 病
- 感染，化脓性，或急性甲状腺炎
- 毒性多结节性甲状腺肿
更多 鉴别诊断指南
- 甲状腺疾病：评估和管理
- 甲状腺病：评估和管理
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甲状腺功能低下症
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