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亚临床甲状腺疾病患者甲状腺功能变化的初步观察。

Preliminary observation of thyroid function changes in subclinical thyroid diseases.

机构信息

Clinical Laboratory, Huanghua Boai Hospital, Cangzhou, Hebei, China.

Cangzhou Medical College, Cangzhou, Hebei, China.

出版信息

Technol Health Care. 2023;31(5):1715-1722. doi: 10.3233/THC-220562.

Abstract

BACKGROUND

It is estimated that 1.95% and 5.55% of adults in China suffer from subclinical thyroid diseases, which is difficult to diagnose and treat.

OBJECTIVE

This study aimed to explore the development and prognosis of subclinical thyroid diseases to provide a reference from our single center experience.

METHODS

A total of 240 cases from April 2019 to August 2021 in the laboratory information system database of Huanghua Development Boai Hospital were retrospectively analyzed. Binary logistic regression was conducted to analyze odds ratio (OR) of subclinical thyroid disease types returning to a normal state.

RESULTS

Among the patients hypothyroidism Ia and hyperthyroidism Ia were the most common type with conversion to the normal state (P< 0.001). TSH level of patients with conversion to a normal state was significantly lower than that of those who developed to abnormal disease (P= 0.015). The OR values of hyperthyroidism Ia and hypothyroidism Ia that returned to a normal state compared with hyperthyroidism Ib were 2.659 (1.159 ∼ 6.096, P= 0.021) and 3.138 (1.1.278 ∼ 7.709, P= 0.013), respectively. The OR value of hypothyroidism Ib that returned to normal compared with hyperthyroidism Ib was 0.629 (0.131 ∼ 3.010, P= 0.561). Thyroid hormone levels, age, and gender at first diagnosis were not impact factor for prognosis of subclincal thyroid disease (P> 0.05).

CONCLUSION

Cases with grade hypothyroidism Ia and hyperthyroidism Ia are more likely to revert to normal state than other subclinical thyroid diseases. TSH reference range should be explored for diagnosis and treatment.

摘要

背景

据估计,中国有 1.95%和 5.55%的成年人患有亚临床甲状腺疾病,其诊断和治疗具有一定难度。

目的

本研究旨在探讨亚临床甲状腺疾病的发展和预后,为我们的单中心经验提供参考。

方法

回顾性分析 2019 年 4 月至 2021 年 8 月在黄骅开发区博爱医院实验室信息系统数据库中的 240 例患者,采用二项逻辑回归分析亚临床甲状腺疾病类型恢复正常状态的比值比(OR)。

结果

在甲状腺功能减退症 Ia 和甲状腺功能亢进症 Ia 患者中,最常见的类型是转化为正常状态(P<0.001)。转化为正常状态患者的 TSH 水平明显低于发展为异常疾病患者(P=0.015)。与甲状腺功能亢进症 Ib 相比,甲状腺功能亢进症 Ia 和甲状腺功能减退症 Ia 恢复正常状态的 OR 值分别为 2.659(1.159~6.096,P=0.021)和 3.138(1.1.278~7.709,P=0.013)。与甲状腺功能亢进症 Ib 相比,甲状腺功能减退症 Ib 恢复正常的 OR 值为 0.629(0.131~3.010,P=0.561)。首次诊断时的甲状腺激素水平、年龄和性别不是亚临床甲状腺疾病预后的影响因素(P>0.05)。

结论

亚临床甲状腺疾病中,等级较轻的甲状腺功能减退症 Ia 和甲状腺功能亢进症 Ia 更有可能恢复正常状态。应该探索 TSH 参考范围以用于诊断和治疗。

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