Torre Roberto, Del Monte Patrizia, Bernasconi Donatella, Marugo Alessandro, Poggi Patrizia, Leoncini Rossella, Marugo Mario
UO Medicina Interna, Ospedale S.Nicolò, Levanto.
Recenti Prog Med. 2004 Jun;95(6):308-11.
In elderly patients, thyroid diseases may remain undiagnosed due to the lack of specificity of the clinical presentation. Thyroid function alterations seem to be more common in older persons than in adults. The aim of our study was to evaluate the incidence of thyroid function alterations in 300 elderly patients admitted to the division of Internal Medicine of the local hospital in Levanto, in a one-year period. Thyroid function alterations were discovered in 12.6% of the patients and considering the group of patients in whom a thyroid function alteration was demonstrated, 45% of them were affected by hypothyroidism (10.7% overt primary hypothyroidism, 28.9% sub-clinical hypothyroidism, 5.4% hypothyroidism secondary to hypopituitarism), 15.6% by hyperthyroidism (overt 7.8% , subclinical 7.8%), and 39.4% showed a low T3 syndrome. Our data confirm the high incidence of previously unrecognized thyroid diseases in the elderly patients admitted to an hospital and the profit that these patients can receive from the appropriate diagnosis at the admission and justify the cost of routine testing for FT4 and TSH in every person at hospital admission.
在老年患者中,由于临床表现缺乏特异性,甲状腺疾病可能仍未被诊断出来。甲状腺功能改变在老年人中似乎比成年人更常见。我们研究的目的是评估在一年时间里,莱万托当地医院内科收治的300例老年患者中甲状腺功能改变的发生率。在12.6%的患者中发现了甲状腺功能改变,在已证实有甲状腺功能改变的患者组中,45%的患者患有甲状腺功能减退(10.7%为显性原发性甲状腺功能减退,28.9%为亚临床甲状腺功能减退,5.4%为垂体功能减退继发的甲状腺功能减退),15.6%的患者患有甲状腺功能亢进(显性7.8%,亚临床7.8%),39.4%的患者表现为低T3综合征。我们的数据证实了在入院的老年患者中,以前未被识别的甲状腺疾病的高发生率,以及这些患者从入院时的适当诊断中所能获得的益处,并证明了在医院入院时对每个人进行FT4和TSH常规检测的成本是合理的。