摘要
老年甲亢的患病率在0.5%-6.0%之间,女性为男性的4-5倍;毒性多结节性甲状腺肿、毒性弥漫性甲状腺肿、医源性甲亢和毒性甲状腺腺瘤是其主要病因;其临床表现具有特殊性和不典型性,极易误诊、漏诊;临床诊断主要依赖甲状腺激素检测,而较少依赖临床表现;老年甲亢患者中,多结节性毒性甲状腺肿宜采用131I治疗,重度甲状腺肿引起压迫症状者应选择手术治疗,Graves患者宜采用抗甲状腺药物治疗,亚临床甲亢患者多不需要治疗而要进行长期随访。
The prevalence of hyperthyroidism in elderly populations ranged between O. 5% and 6%. Female to male is 4 - 5 to 1. Toxic muhinodular goiter, Graves' disease, iatrogenic thyrotoxicosis and toxic adenoma are the most frequent etiological sequence in the elderly patients with hyperthyroidism. Their clinical characters are unusual and no typical manifestions, which always result in misdiag- noses. The clinical diagnoses commonly depend on the assays of thyroid hormones, not on clinical symptoms. Radioiodine administra- tion was the definitive therapy of choice in most elderly patients with hyperthyroidism, especially in those with nodular thyroid diseases. Surgery was an option for patients with large and compressive goiters. On the contrary, thionamide drugs were mainly employed in pa- tients with Graves' disease. No active therapy was needed, but long-term follow-up is frequently recommended in most of older patients with sub-clinical hyperthyroidism.
出处
《川北医学院学报》
CAS
2007年第6期521-525,共5页
Journal of North Sichuan Medical College
关键词
老年人
甲亢
诊断
治疗
临床特点
The elderly
Hyperthyroidism
Diagnosis
Therapy
Clinical characters