原发性甲状腺机能亢进症术后甲状腺功能异常的原因探讨(附30例报告)

Causes of thyroid malfunction after subtotal resection for primary hyperthyroidism (a report of 30 cases)

目的 探讨原发性甲状腺机能亢进症（ 甲亢） 术后甲状腺功能异常的各种原因。方法 对３０ 例原发性甲亢患者术前、术后的临床资料及术后的甲状腺功能状态进行分析。结果 术后随访１ 年，复发３ 例，转为甲状腺功能减退（ 甲减）４ 例。复发与甲减者，术前、术后的抗甲状腺球蛋白抗体（ＴＧＡ） 及抗甲状腺微粒体抗体（ＴＭＡ） 均较术后功能正常者明显升高（ Ｐ ＜ ０ ．０５ ） ，而与腺体残留量无明显关系（ Ｐ ＞ ０ ．０５ ） 。结论 ＴＧＡ，ＴＭＡ 的检测对原发甲亢术后的预后判断有重要意义。

Objective To investigate the causes of thyroid function after subtotal resection for primary hyperthyroidism (PHT). Methods Pre and post operative clinical data, post operative thyroid function in 30 cases of PHT were assessed. Results 3 cases recurred and 4 altered to hypothyroidism one year after operation. Before and after operation, both TGA and TMA were increased significantly (P<0.05) either in recurrent cases or in alterative ones. However, no obvious relationship was found between the remaining size of thyroid gland and its function(P>0.05). Conclusions As for patients with PHT, monitoring TGA and TMA before and after operation is of importance to predicting the prognosis.