[甲状腺功能正常期伴有和不伴有功能自主性的甲状腺肿：一项比较]
[Euthyroid goiter with and without functional autonomy in the euthyroid phase: a comparison].
作者信息
Hillenhinrichs H, Emrich D
机构信息
Nuklearmedizinischen Abteilung, Klinikum der Universität Göttingen, Deutschland.
出版信息
Nuklearmedizin. 1998 May;37(3):95-100.
AIM
Analysis of functional autonomy in euthyroid goitre.
METHODS
In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine.
RESULTS
Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global 99mTc thyroid uptake of > or = 3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy.
CONCLUSION
To diagnose and treat adaequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable.
目的
分析甲状腺功能正常的甲状腺肿的功能自主性。
方法
在碘中度缺乏地区，对163例无功能自主性的甲状腺肿患者和179例有功能自主性的甲状腺肿患者进行比较，所有患者临床甲状腺功能均正常，比较内容包括性别、年龄、体征和症状、超声检查结果、有无抑制的定性和定量闪烁扫描、促甲状腺激素释放激素（TRH）试验、激素浓度以及尿碘排泄情况。
结果
年龄、体征和症状、甲状腺体积及结构对诊断的贡献不足。为检测功能自主性，抑制状态下的定量闪烁扫描优于TRH试验。15%有功能自主性的患者观察到激素浓度升高。抑制状态下全身99m锝甲状腺摄取率≥3%表明自发性甲状腺功能亢进风险较高。20%有功能自主性的患者存在这种情况。
结论
为充分诊断和治疗甲状腺功能正常的甲状腺肿的功能自主性，定量闪烁扫描、促甲状腺激素（TSH）测定和激素浓度测定是必不可少的。
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