Hegedüs L, Hansen J M, Feldt-Rasmussen U, Hansen B M, Høier-Madsen M
Department of Internal Medicine and Endocrinology F, Herlev Hospital, Denmark.
Clin Endocrinol (Oxf). 1991 Sep;35(3):235-8. doi: 10.1111/j.1365-2265.1991.tb03528.x.
It has been postulated that a decrease in thyroid size can be achieved by thyroxine treatment in patients with goitrous Hashimoto's thyroiditis but no objective data are available. We have therefore investigated the influence of thyroxine treatment on ultrasonically determined thyroid size. We also measured serum antithyroid peroxidase antibodies.
Consecutive patients with goitrous Hashimoto's thyroiditis was studied.
Thirteen women participated; all had goitrous thyroiditis.
To render them euthyroid thyroxine was given for 24 months.
Thyroid size was measured ultrasonically and antithyroid peroxidase antibodies were measured using a commercial radioimmunological method.
Concomitant with the gradual increase in serum free thyroxine and free triiodothyronine index values and a fall in serum thyrotrophin level, a gradual decrease in thyroid volume from 50.4 +/- 6.8 ml (mean +/- SEM) to 34.1 +/- 5.7 ml (32%), P less than 0.001 was demonstrated. Antithyroid peroxidase antibodies were present in high concentrations in all subjects but the mean serum level was not significantly changed at 24 months after initiation of treatment.
A clinically significant reduction in thyroid volume related to normalization of thyroid function but unrelated to changes in antithyroid peroxidase antibody can be achieved during L-thyroxine treatment of hypothyroid goitrous Hashimoto's thyroiditis.
据推测，甲状腺素治疗可使桥本甲状腺炎伴甲状腺肿患者的甲状腺体积减小，但尚无客观数据支持。因此，我们研究了甲状腺素治疗对超声测定的甲状腺大小的影响。我们还检测了血清抗甲状腺过氧化物酶抗体。
对连续性桥本甲状腺炎伴甲状腺肿患者进行研究。
13名女性参与研究；均患有甲状腺肿性甲状腺炎。
给予甲状腺素治疗24个月以使患者甲状腺功能正常。
采用超声测量甲状腺大小，使用商业放射免疫法检测抗甲状腺过氧化物酶抗体。
随着血清游离甲状腺素和游离三碘甲状腺原氨酸指数值逐渐升高以及血清促甲状腺素水平下降，甲状腺体积从50.4±6.8ml（均值±标准误）逐渐减小至34.1±5.7ml（减小32%），P<0.001。所有受试者抗甲状腺过氧化物酶抗体浓度均较高，但治疗开始24个月时血清平均水平无显著变化。
在对甲状腺功能减退的桥本甲状腺炎伴甲状腺肿患者进行左甲状腺素治疗期间，可实现与甲状腺功能正常化相关但与抗甲状腺过氧化物酶抗体变化无关的具有临床意义的甲状腺体积减小。
