Brabant G
Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover.
MMW Fortschr Med. 2004 Feb 26;146(9):30-2, 34.
Uncharacteristic clinical symptoms such as cardiac arrhythmias, restlessness, changes in weight or hair loss may signify hyperthyroidism, whereas impairment of physical or mental vigilance may be a manifestation of hypothyroidism. In many cases the diagnosis can be established only on the basis of laboratory investigations, and, on account of the difficulty in establishing a differential diagnosis, these should not be stinted. However, when it comes to interpreting findings, consideration must be given to drug interference, such diseases as the nephrotic syndrome, serious general diseases or pregnancy. In the event of pathological laboratory findings, ultrasonography and scintigraphy are helpful further diagnostic measures. Antihyperthyroid drugs, surgery or radioiodine therapy are the leading therapeutic options for hyperthyroidism. As in the case of hypothyroidism treated with L-thyroxine, the primary target parameter is titration of TSH into the normal range.
诸如心律失常、烦躁不安、体重变化或脱发等不典型临床症状可能意味着甲状腺功能亢进,而身体或精神警觉性受损可能是甲状腺功能减退的表现。在许多情况下,诊断只能基于实验室检查来确定,并且由于难以进行鉴别诊断,这些检查不应节省。然而,在解释检查结果时,必须考虑药物干扰、肾病综合征等疾病、严重的全身性疾病或妊娠。如果实验室检查结果异常,超声检查和闪烁扫描是有用的进一步诊断措施。抗甲状腺药物、手术或放射性碘治疗是甲状腺功能亢进的主要治疗选择。与用左甲状腺素治疗甲状腺功能减退的情况一样,主要目标参数是将促甲状腺激素滴定到正常范围内。