Serra M, Méndez M A, Davins J, Borrell M, Baxarias J, Ríos L
Area Básica de Salud La Mina, Sant Adrià del Besós, Barcelona.
Aten Primaria. 1995 Apr 30;15(7):457-60.
To describe the thyroid pathology seen at our health centre (HC) and its evolution.
A longitudinal, retrospective study.
La Mina HC, Sant Adrià de Besòs, Barcelona.
Patients older than 14 who, between January 1985 and June 1993, had presented functional or morphological thyroid function disorders. They belonged to four general medical practices which attended 5,834 people.
160 people (2.74%) presented thyroid disorders at some point. Average age was 56.5 +/- 15.6 years. Women presented thyroid pathology more often: 142 (88.7%) against 18 (11.3%). The commonest disorder was Hypothyroidism with 68 cases (42.5%). 38 (58.8%) were sub-clinical (HS). Toxic diffuse goitre (TDG) was the most common diagnosis among the 15 cases of hyperfunction. Among morphological disorders, 19 cases of thyroid nodule (3 carcinomas: 2 papillary and 1 follicular) and 16 cases of non-toxic diffuse goitre were recorded. There were 5 cases of hypothyroidism associated with amiodarone treatment. Five women were diagnosed as having exogenous Hyperthyroidism. Of the 38 HS patients, 5 (13.2%) evolved towards Hypothyroidism and 3 died. Average period of observation was 43.6 +/- 27.4 months. At present 122 people (2.09%) present thyroid pathology, with women predominating (4.16% vs 0.35%). The most common diagnoses are: normally functioning goitre (25 cases), HS (20), and primary hypothyroidism in adults (HPA) (16). There are 13 cases of post-surgical hypothyroidism and 11 of autoimmune thyroiditis or probable Hashimoto's disease. The incidence of TDG in the last 5 years is 3 per 10,000 inhabitants per year.
Our work contributes data on thyroid pathology among the population covered by a health centre. A proper procedure for tackling thyroid pathology in primary care could improve care for these patients.
描述我们健康中心（HC）所见到的甲状腺病理情况及其演变。
一项纵向回顾性研究。
巴塞罗那桑特阿德里亚德贝索斯的拉米纳健康中心。
1985年1月至1993年6月期间出现功能性或形态性甲状腺功能障碍的14岁以上患者。他们来自四个普通医疗诊所，这些诊所服务5834人。
160人（2.74%）在某个时间点出现甲状腺疾病。平均年龄为56.5±15.6岁。女性出现甲状腺病理情况更为常见：142例（88.7%），男性18例（11.3%）。最常见的疾病是甲状腺功能减退症，共68例（42.5%）。其中38例（58.8%）为亚临床型（HS）。毒性弥漫性甲状腺肿（TDG）是15例甲状腺功能亢进病例中最常见的诊断。在形态学疾病方面，记录了19例甲状腺结节（3例癌：2例乳头状癌和1例滤泡状癌）和16例非毒性弥漫性甲状腺肿。有5例甲状腺功能减退症与胺碘酮治疗有关。5名女性被诊断为外源性甲状腺功能亢进症。在38例HS患者中，5例（13.2%）发展为甲状腺功能减退症，3例死亡。平均观察期为43.6±27.4个月。目前，122人（2.09%）存在甲状腺病理情况，女性占主导（4.16%对0.35%）。最常见的诊断是：功能正常的甲状腺肿（25例）、HS（20例）和成人原发性甲状腺功能减退症（HPA）（16例）。有13例手术后甲状腺功能减退症和11例自身免疫性甲状腺炎或可能的桥本氏病。过去5年中TDG的发病率为每年每10000名居民中有3例。
我们的工作提供了关于健康中心所覆盖人群中甲状腺病理情况的数据。在初级保健中处理甲状腺病理情况的适当程序可以改善对这些患者的护理。
