超声对泼尼松治疗亚急性甲状腺炎停药指标的判断价值

Diagnostic value of ultrasonography on judgement of prednisone withdraw in subacute thyroiditis

目的探讨二维超声结合彩色多普勒血流显像（CDFI）对亚急性甲状腺炎的诊断价值和泼尼松停用指标的判断。方法66例亚急性甲状腺炎患者应用二维超声结合CDFI效应动态观察甲状腺声像图，在使用泼尼松治疗后，随机分为超声观察停药组36例和临床症状停药组30例，观察两组复发情况。结果声像图主要表现为病灶区回声减低，CDFI示病变周边血流较丰富，病灶内动脉血流特点为低速低阻型。超声观察停药组复发率8．33％（3／36），明显低于临床症状停药组的26．67％（8／30），两组比较差异有统计学意义（P〈0．05）。结论二维超声结合CDFI可以诊断和指导亚急性甲状腺炎的治疗，为病情评价提供客观依据。

Objective To investigate the diagnostic value of two-dimensional and color Doppler ultrasonography on diagnosis and judgement of prednisone withdraw in patients with subacute thyroiditis. Methods Sixty-six patients with clinically proved subacute thyroiditis underwent two-dimensional and color Doppler ultrasonography before treatment of prednisone. The ultrasonographic features and bloodflow distribution in thyroid of these patients were analyzed retrospectively. Target of prednisone withdraw was judged according to ultrasonographic images （36 cases） and clinical symptom （30 cases）. Results The ultrasonographic features of subacute thyroiditis mainly presented as bilateral or unilateral diffussion or focal low echogenicity in the affected thyroid, and color Doppler ultrasonography showed the increased vascularity around the lesions. Intraarterial bloodflow feature was low velocity and low resistance pattern, prednisone withdraw was performed according to ultrasonographic images after the treatment of prednisone, then relapse rate was decreased compared with the group of clinical symptom [8.33%（3/36） vs 26.67%（8/30）] （P 〈 0.05 ）. Conclusion Two-dimensional and color Doppler ultrasonography is highly valuable for diagnosing and treating subacute thyroiditis.