亚临床甲状腺疾病的决策制定。
Decision Making in Subclinical Thyroid Disease.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of North Carolina, Burnett-Womack, CB 7172, Chapel Hill, NC 27599, USA.
Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Bldg. 16, Rm 453S, Ann Arbor, MI 48109, USA.
出版信息
Med Clin North Am. 2021 Nov;105(6):1033-1045. doi: 10.1016/j.mcna.2021.05.014. Epub 2021 Sep 7.
Subclinical thyroid disease is frequently encountered in clinic practice. Although overt thyroid dysfunction has been associated with adverse clinical outcomes, uncertainty remains about the implications of subclinical thyroid disease. Available data suggest that subclinical hypothyroidism may be associated with increased risk of cardiovascular disease and death. Despite this finding, treatment with thyroid hormone has not been consistently demonstrated to reduce cardiovascular risk. Subclinical hyperthyroidism has been associated with increased risk of atrial fibrillation and osteoporosis, but the association with cardiovascular disease and death is uncertain. The decision to treat depends on the degree of thyroid-stimulating hormone suppression and underlying comorbidities.
临床实践中经常会遇到亚临床甲状腺疾病。尽管显性甲状腺功能障碍与不良临床结局相关，但亚临床甲状腺疾病的影响仍存在不确定性。现有数据表明，亚临床甲状腺功能减退症可能与心血管疾病和死亡风险增加相关。尽管有此发现，但甲状腺激素治疗并未始终被证明可降低心血管风险。亚临床甲状腺功能亢进症与心房颤动和骨质疏松症风险增加相关，但与心血管疾病和死亡的关联尚不确定。治疗决策取决于促甲状腺激素抑制的程度和潜在的合并症。
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