自身免疫性甲状腺炎的诊断

Diagnosis of Auto-immune Thyroiditis

本文报告51例自身免疫性甲状腺炎,均有甲状腺组织病理证实,其中40岁以上女性38例,甲状腺肿大较典型者9例,余为单结节,对称或不对称性多结节,异位或巨大甲状腺等。51例中伴有甲癌、Graves 病(甲亢)、腺瘤各2例,甲状腺囊肿1例。本文重点讨论 AIT的不典型特点,以提高对本病的诊断率。

Fifty one cases of autoimmune thyroiditis(AIT)were reported.46 postoperativecases were pathologicaly confirmed and the other 5 had pathological diagnosis throughneedle aspiration biopsy.In this series 50 were female and 1 male patients.The ageranged from 25 to 72 years,averaging 47,74.5% of them were over 40 years,9 patientshad typical goitres and the other 42 particularly showed single goitres or multiplenodular thyroids,retrosternal thyroids or thyromegaly.Palpation on thyroids re-vealed hard,moderate and soft.In the 51 cases of AIT,2 were complicated withcarcinoma,while 2 with adenoma,2 Graves's disease and 1 cyst of thyroid.All the 5subacute cases had tenderness,2 in the 5 cases were complicated with carcinoma andpresented adenoma-like on single side.Isotope scan showed cold node presented withabnormal thyroid functions.Thyroid Autoantibody was assayed in 11 cases of 51 pa-tients with AIT,the positive rate being 72.7%.Atypical cases comprised the greatpart of this series.The misdiagnosis rate was 76.5%.It was suggested that AITshould be suspected in female patients over 40-years old with abnormal thyroid fun-ction or other autoimmune diseases,whether the disease developed rapidly or slowlyand what ever character the goitre was.Assay of thyroid auto antibody wasimportant.In general surgical operation was not necessary.