核素甲状腺显像在哺乳期亚急性甲状腺炎与Graves病诊断与鉴别诊断中的价值

Value of radionuclide thyroid imaging in differential diagnosis of subacute thyroiditis during breast-feeding and Graves disease

目的研究核素甲状腺显像在哺乳期亚急性甲状腺炎(亚甲炎)与Graves病(GD)诊断与鉴别中的价值。方法回顾性分析43例血清检测甲状腺激素水平高的哺乳期妇女的诊治及随访临床资料,分为亚甲炎组(24例)和GD组(19例)。另选20例健康哺乳期妇女作为对照(C)组。分析核素甲状腺显像,检测血清抗甲状腺过氧化物酶抗体(TPOAb)。结果亚甲炎组:甲状腺显影不清晰或仅见轮廓,口腔腺体及乳房过度显影。GD组:甲状腺清晰显影,口腔腺体及乳房不显影或仅见模糊影。亚甲炎组显影采集时间长于对照组及GD组(P<0.01);GD组显影采集时间短于C组(P<0.01)。GD组TPOAb高于亚甲炎组和C组(P<0.01)。亚甲炎组红细胞沉降率(ESR)高于GD组和C组(P<0.01)。结论核素甲状腺显像在哺乳期亚甲炎与GD诊断与鉴别中有着重要的价值。联合血清TPOAb和ESR检测能提高其诊断与鉴别的能力。

Objective To study the value of radionuclide thyroid imaging in differential diagnosis of subacute thyroiditis and Graves disease（GD）.Methods Data of 43 breast-feeding women patients with high serum thyroid function were retrospectively analyzed,who were divided into 2 groups of ST（19 cases with subacute thyroiditis） and GD（24 cases with GD）.The radionuclide thyroid imaging and serum antithyroid peroxidase antibody（TPOAb） were analyzed.Results Thyroid imaging in group ST was not clear or just showing the outline,but oral and breast glands were over-developed,which in group GD was clear,but oral and breast glands did not well develop or only the vague shadow was seen.The developing inflammatory acquisition time was longer in group ST than that in groups of C and GD（P〈0.01）,which was shorter in group GD than that in group C（P〈0.01）.Serum TPOAb was higher,but erythrocyte sedimentation rate（ESR） was lower,in group GD than those in groups of ST and C（P〈0.01）.Conclusion Radionuclide thyroid imaging is valuable in differential diagnosis of subacute thyroiditis and GD in breast-feeding women.The accuracy rate of differencial diagnosis may be raised if combined examing serum TPOAb and ESR.