[全科医生与甲状腺功能异常筛查]

[The general practitioner and abnormal thyroid function screening].

作者信息

Vanderpas J

机构信息

Laboratoire de Biologie Clinique, C.I.U. Ambroise Paré, Mons.

出版信息

Rev Med Brux. 1998 Sep;19(4):A244-7.

PMID:9805952

Abstract

The high frequency of thyroid diseases justifies the measurement of serum TSH in regular checkups. If found normal in non-goitrous patients, this measurement is self-sufficient, but pregnant women should also be screened for antithyroid antibodies because they have an increased risk of post-partum Hashimoto's disease. Abnormal TSH concentrations suggesting hyperthyroidism (TSH < 0,3 mU/l) or hypothyroidism (TSH > 5 mU/l) need free T4 and free T3 complementary determinations, and positive anti-thyroid antibodies may indicate Graves-Basedow's disease in case of hyperthyroidism or Hashimoto's disease in case of hypothyroidism. More recently, measurement of anti-TSH-receptor antibodies had allowed the diagnosis and a follow-up tool in some cases of thyroid diseases.

摘要

甲状腺疾病的高发性使得在定期体检中检测血清促甲状腺激素（TSH）成为必要。在非甲状腺肿患者中，如果TSH检测结果正常，这一检测就足够了，但孕妇还应筛查抗甲状腺抗体，因为她们患产后桥本氏病的风险增加。TSH浓度异常提示甲状腺功能亢进（TSH<0.3 mU/l）或甲状腺功能减退（TSH>5 mU/l）时，需要进行游离甲状腺素（free T4）和游离三碘甲状腺原氨酸（free T3）的补充测定，抗甲状腺抗体呈阳性在甲状腺功能亢进时可能提示格雷夫斯-巴塞多氏病（Graves-Basedow's disease），在甲状腺功能减退时可能提示桥本氏病。最近，抗促甲状腺激素受体抗体的检测在某些甲状腺疾病病例中已成为诊断和随访的工具。