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[甲状腺自身免疫性疾病]

[Autoimmune diseases of the thyroid gland].

作者信息

Allelein S, Feldkamp J, Schott M

机构信息

Funktionsbereich Spezielle Endokrinologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.

Klinik für Allgemeine Innere Medizin, Endokrinologie, Diabetologie und Infektiologie, Klinikum Bielefeld Mitte, Bielefeld, Deutschland.

出版信息

Internist (Berl). 2017 Jan;58(1):47-58. doi: 10.1007/s00108-016-0171-2.

Abstract

Autoimmune diseases of the thyroid gland are considered to be the most frequent cause of thyroid gland disorders. Autoimmune thyroid diseases consist of two subgroups: autoimmune thyroiditis (AIT) and Graves' disease. The AIT is the most common human autoimmune disease. Infiltration of the thyroid gland with cytotoxic T‑cells can lead to an initial thyrotoxicosis und during the course to hypothyroidism due to destruction of the thyroid gland. Substitution with Levothyroxine is indicated for manifest hypothyroidism and subclinical hypothyroidism with increased thyroid antibodies with the intention of normalizing the serum thyroid stimulating hormone (TSH). Graves' disease is characterized by the appearance of stimulating TSH receptor antibodies leading to hyperthyroidism. Endocrine ophthalmopathy may also occur. Ablative therapy with radioiodine therapy or thyroidectomy is administered to patients with Graves' disease without remission after at least 1 year of antithyroid drug therapy.

摘要

甲状腺自身免疫性疾病被认为是甲状腺疾病最常见的病因。自身免疫性甲状腺疾病包括两个亚组:自身免疫性甲状腺炎(AIT)和格雷夫斯病。AIT是最常见的人类自身免疫性疾病。细胞毒性T细胞浸润甲状腺可导致最初的甲状腺毒症,并在病程中由于甲状腺破坏而导致甲状腺功能减退。对于明显的甲状腺功能减退和甲状腺抗体升高的亚临床甲状腺功能减退,使用左甲状腺素替代治疗的目的是使血清促甲状腺激素(TSH)正常化。格雷夫斯病的特征是出现刺激TSH受体抗体,导致甲状腺功能亢进。也可能发生内分泌性眼病。对于接受抗甲状腺药物治疗至少1年仍未缓解的格雷夫斯病患者,采用放射性碘治疗或甲状腺切除术进行消融治疗。

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