最后审阅: 6 十一月 2021
最后更新: 18 二月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 怕热
  • 烦躁
  • 小且无痛性甲状腺肿
  • 发抖

其他诊断因素

  • 心悸
  • 体重减轻
  • 过度疲乏
  • 腹胀
  • 肌肉痉挛
  • 体重升高
  • 注意力不集中
  • 怕冷
  • 心动过速

危险因素

  • 产后
  • 女性
  • 甲状腺过氧化物酶(TPO)抗体
  • 免疫调节治疗
  • 锂剂治疗
  • 1型糖尿病及其他自身免疫性疾病
  • 自身免疫家族史

诊断性检查

首要检查

  • 促甲状腺素 (TSH)
  • 血清游离T4 和 T3
  • 甲状腺过氧化物酶(TPO)抗体
  • 促甲状腺激素受体抗体 (TRAb)
  • 4、6或24小时的放射性碘摄取率
  • 总T3/T4 比值

需考虑的检查

  • 锝-99 高锝酸盐扫描
  • 血清甲状腺球蛋白
  • 甲状腺活检

新兴检查

  • 彩色血流多普勒超声

治疗流程

撰稿人

作者

Petros Perros, MD

Consultant

Department of Endocrinology

Newcastle upon Tyne Hospitals NHS Foundation Trust

Newcastle upon Tyne

UK

利益声明

PP has been an invited speaker on thyroid topics for the British Endocrine Societies, the American Association of Clinical Endocrinologists Gulf Chapter, Lebanese Society of Endocrinology Diabetes and Lipids, Emirates Thyroid Congress, Cyprus Endocrine Society, European Group On Graves Orbitopathy, European Thyroid Association and Azerbaijan State Advanced Training Institute for Doctors. He has received honoraria for speaking at meetings organised by the American Association of Clinical Endocrinologists Gulf Chapter, the Lebanese Society of Endocrinology Diabetes and Lipids and Azerbaijan State Advanced Training Institute for Doctors and has done consultancy work for IBSA Institut Biochemie SA.

鸣谢

Dr Petros Perros would like to gratefully acknowledge Dr Douglas S. Ross, the previous contributor to this monograph. DSR declares that he has no competing interests.

同行评议者

John Lazarus, MA, MD, FRCP, FACE, FRCOG

Centre for Endocrine and Diabetes Sciences

Cardiff University School of Medicine

University Hospital of Wales

Heath Park

Cardiff

UK

利益声明

JL declares that he has no competing interests.

Ronald Merrell, MD

Professor of Surgery

Virginia Commonwealth University

Richmond

VA

利益声明

RM declares that he has no competing interests.

内容使用需遵循免责声明