特殊人群甲状腺功能减退症诊治的问题与展望

The problems and prospects of diagnosis and treatment of hypothyroidism in special populations

我国甲状腺疾病患病率逐年升高,甲状腺功能减退症(甲减)尤为突出。本文就特殊人群甲减诊治的临床问题进行论述,包括肥胖、老年、儿童及孕妇在内的特殊人群。肥胖导致甲减的发病机制和干预措施是研究的前沿热点;老年人亚临床甲减患病率最高,而诊断标准和治疗策略还存在争议;妊娠期亚临床甲减和低甲状腺素血症的危害和治疗是目前国际上的焦点问题;儿童的先天性甲减的筛查和诊治也存在不容忽视的问题,还需要开展高质量临床研究为临床诊治提供依据,深入开展相关机制研究为构建甲减的科学防治体系建立基础。

The prevalence of thyroid diseases in China continues to increase,especially for hypothyroidism.This article focuses on the existing problems in the diagnosis and treatment of hypothyroidism in special groups,including obese patients,the elderly,children and pregnant women.The pathogenesis and intervention measures of obesity-induced hypothyroidism have been the hot research frontiers.The prevalence of subclinical hypothyroidism in the elderly is the highest,while its diagnostic criteria and treatment strategies are still controversial.The hazard and treatment of subclinical hypothyroidism and hypothyroxinemia during pregnancy have now become an international concern.And there also exist some problems in the screening,diagnosis and treatment of congenital hypothyroidism in children.So it is urgent to carry out high-quality clinical research to provide theoretical basis for clinical diagnosis and treatment,and carry out in-depth research on related mechanisms to establish a foundation for the construction of a scientific prevention and treatment system for hypothyroidism.