儿童慢性淋巴细胞性甲状腺炎临床特点及转归

Chronic lymphocytic thyroiditis in children: clinical characteristics and follow-up

为探讨儿童慢性淋巴细胞性甲状腺炎（CLT）的临床特点及预后，对1988年以来收治的77例患儿的临床资料进行了回顾性分析。结果：无症状弥漫性甲状腺肿大伴甲状腺自身抗体阳性者66例。甲状腺功能（简称甲功）正常者38例，代偿性甲状腺功能减低（简称代甲减）7例，甲状腺功能减低（简称甲减）22例和甲状腺功能亢进（简称甲亢）5例。随访的64例患儿中90％（27／30）原甲功正常者功能正常持续数年；5／7原代甲减、59．1％（13／22）甲减及3／5甲亢患儿，甲功恢复正常，并持续至治疗后数年。结果提示儿童CLT可存在不同的甲功状态；大部分患儿预后良好，甲状腺炎所致甲功受损并非均为永久性的，部分患儿甲功可恢复正常。

Seventy-seven children with chronic lymphocytic thyroiditis (CLT) were studied. Sixty-six out of 77 patients (86%) had an asymptomatic diffuse goiter with positive antithyroglobulin and antimicrosomal antibody The laboratory tests demonstrated that 38 cases were euthyroid, while 7, 27,and 5 cases had compensated hypothyroidism, hypothyroidism and hyperthyroidism, respectively. Six-ty-four cases were followed up. The results showed that thyroid function in 90% (27/30 ) of patientswho were initially euthyroid had remained normal for several years and 71.4 % (5/7), 59. 1 (13/22),and 60% (3/5) of patients who had lnitially compensated hypothyroidism, hypothyroidism and hyper-thyroidism, respectively, had reverted to an euthyroid status which remained for several years after dis-continuation of therapy. lt ls Suggested that CLT in children may have different thyroid status and theprognosis of the disease is favourable in most patients. Not all thyroid failure resulting from thyroiditis ispermanent and apart of patients can recover to a euthyroid status.