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亚临床甲状腺功能减退症。了解是决策的关键。

Subclinical hypothyroidism. Understanding is the key to decision making.

作者信息

Cushing G W

机构信息

Section of Endocrinology and Metabolism, Lahey Clinic Medical Center, Burlington, MA 01805.

出版信息

Postgrad Med. 1993 Jul;94(1):95-7, 100-2, 106-7.

PMID:8321788
Abstract

Subclinical hypothyroidism is defined by elevated concentrations of thyrotropin (TSH) and normal levels of serum thyroxine in the absence of overt symptoms. Autoimmune thyroid disease is the most frequent cause. Prevalence is between 2.5% and 10%, depending on the patient population. The disorder may not be as asymptomatic as previously thought; mild but consistent hypothyroid symptoms may exist in 25% to 50% of patients. Subtle cardiac defects may be present and are probably most clinically relevant in patients with existing heart disease. Mild disturbances in cholesterol metabolism are a more common finding. Treatment of subclinical hypothyroidism must be individualized. The lowest dose of levothyroxine sodium (Levothroid, Levoxine, Synthroid) required to normalize TSH levels and improve symptoms yet avoid unnecessary side effects should be used.

摘要

亚临床甲状腺功能减退症的定义是促甲状腺激素(TSH)浓度升高且血清甲状腺素水平正常,同时不存在明显症状。自身免疫性甲状腺疾病是最常见的病因。患病率在2.5%至10%之间,具体取决于患者群体。这种疾病可能并不像之前认为的那样没有症状;25%至50%的患者可能存在轻微但持续的甲状腺功能减退症状。可能存在细微的心脏缺陷,这在患有现有心脏病的患者中可能在临床上最为相关。胆固醇代谢的轻度紊乱是更常见的表现。亚临床甲状腺功能减退症的治疗必须个体化。应使用能使TSH水平正常化并改善症状同时避免不必要副作用的最低剂量左甲状腺素钠(优甲乐、雷替斯、左旋甲状腺素)。

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