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自身免疫性甲状腺疾病的一般特征及相关并发症。

General properties of autoimmune thyroid diseases and associated morbidities.

机构信息

Clinic of Child Health and Disease, Afyonkarahisar University of Health Sciences Hospital, Erkmen, Afyonkarahisar 03200, Turkey, Phone: +90 444 03 04, Fax: +90 0272 246 33 44.

Clinic of Child Endocrinology, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey.

出版信息

J Pediatr Endocrinol Metab. 2020 Apr 28;33(4):509-515. doi: 10.1515/jpem-2019-0331.

Abstract

Background Autoimmune thyroid diseases (ATDs) can be classified into two basic diseases: Graves' disease (GD) and Hashimoto's thyroiditis (HT). Here, we review the effectiveness of laboratory and imaging methods used for the early diagnosis of ATD and draw attention to methods that may improve screening. Methods Retrospective data of 142 patients diagnosed with ATD between January 2010 and December 2015 at our paediatric endocrinology clinic were used. Sociodemographic characteristics, clinical findings, treatments and follow-up data of patients were statistically evaluated. Results Of the ATD cases, 81% (n = 115) were female. The median age was 12.5 ± 3.5 (range 1-17) years and 91% (n = 129) of patients were in puberty. There was a significant positive correlation between the height (standard deviation score) and follow-up time for patients with HT (r = 0.156, p < 0.01). Thyroglobulin antibody (TgAb) positivity was found in 75% (45/60) of females with a positive maternal ATD history (p = 0.045). Thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) values were significantly altered during the treatment follow-up period in female patients with GD and HT, while only fT4 values were found to be significantly altered in boys with HT. Conclusion Although GD and HT have similar mechanisms, they differ in terms of treatment duration and remission and relapse frequencies. Ultrasonography (USG) screening is a non-invasive procedure that is suitable for all patients with ATD. Based on our results, TgAb could be useful in the screening of girls with a history of maternal ATD.

摘要

背景 自身免疫性甲状腺疾病(ATD)可分为两种基本疾病:格雷夫斯病(GD)和桥本甲状腺炎(HT)。在这里,我们回顾了用于 ATD 早期诊断的实验室和影像学方法的有效性,并提请注意可能改善筛查的方法。

方法 使用我们儿科内分泌诊所 2010 年 1 月至 2015 年 12 月期间诊断为 ATD 的 142 名患者的回顾性数据。对患者的社会人口统计学特征、临床发现、治疗和随访数据进行了统计学评估。

结果 在 ATD 病例中,81%(n=115)为女性。中位年龄为 12.5±3.5(范围 1-17)岁,91%(n=129)的患者处于青春期。HT 患者的身高(标准差评分)与随访时间之间存在显著正相关(r=0.156,p<0.01)。在有阳性母体 ATD 病史的女性中(n=45),发现甲状腺球蛋白抗体(TgAb)阳性率为 75%(p=0.045)。GD 和 HT 女性患者在治疗随访期间,促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(fT3)、游离甲状腺素(fT4)值均发生显著变化,而 HT 男孩仅发现 fT4 值发生显著变化。

结论 尽管 GD 和 HT 的发病机制相似,但在治疗持续时间、缓解和复发频率方面存在差异。超声检查(USG)筛查是一种适用于所有 ATD 患者的非侵入性程序。根据我们的结果,TgAb 可用于筛查有母体 ATD 病史的女孩。

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