Locke W
Postgrad Med. 1982 Mar;71(3):118-25, 128-9. doi: 10.1080/00325481.1982.11716017.
In hyperthyroidism, the primary objective of therapy is to reduce secretion of thyroid hormone, which can be accomplished in various ways. The stimulus to hypersecretion can be removed in some causes of hyperthyroidism; in others, hormone synthesis and release can be inhibited by drugs such as thioamides, adrenergic blocking agents, or possibly lithium or glucocorticoids. Radioactive iodine is indicated for primary therapy of uncomplicated hyperthyroidism due to Graves' disease in persons over 30 years of age (myxedema may be a complication) and for treatment of autonomous thyroid adenoma in patients who are not suitable candidates for surgery. Surgical ablation is preferred for some causes of hyperthyroidism but may induce postoperative hypothyroidism. Hypothyroidism due to thyroid failure usually presents few therapeutic difficulties and can be managed simply by long-term hormone replacement. Before hormone replacement is prescribed for secondary or tertiary hypothyroidism, the other pituitary functions should be assessed.
在甲状腺功能亢进症中，治疗的主要目标是减少甲状腺激素的分泌，这可以通过多种方式实现。在某些甲状腺功能亢进症病因中，可去除导致分泌过多的刺激因素；在其他病因中，硫代酰胺、肾上腺素能阻滞剂或可能的锂盐或糖皮质激素等药物可抑制激素的合成与释放。放射性碘适用于30岁以上因格雷夫斯病导致的单纯性甲状腺功能亢进症的初始治疗（黏液性水肿可能是一种并发症），以及不适于手术的自主性甲状腺腺瘤患者的治疗。对于某些甲状腺功能亢进症病因，手术切除是首选，但可能会导致术后甲状腺功能减退。甲状腺功能减退通常在治疗上没有太大困难，通过长期激素替代即可简单处理。在为继发性或三发性甲状腺功能减退症开激素替代药物之前，应评估其他垂体功能。
