成人非老年亚临床甲状腺功能异常的管理

Management of subclinical thyroid dysfunction in non-elderly adults.

亚临床甲状腺功能异常在人群中普遍常见,其诊断依赖于实验室检查结果,分为亚临床甲状腺功能减退症和亚临床甲状腺功能亢进症。文章仅涉及成人非老年内源性亚临床甲状腺功能异常,结合近年国内外多个临床指南,重点介绍亚临床甲状腺功能减退和亚临床甲亢非妊娠和妊娠人群相关的管理内容。文章管理建议仅针对非老年(70岁以下的亚临床甲减和65岁以下的亚临床甲状腺功能亢进)患者。迄今仍缺乏良好设计的大型前瞻性随机对照试验评估亚临床甲状腺功能异常治疗的研究,这方面进展值得关注。

Subclinical thyroid dysfunction is a common problem.Its diagnosis is based on the results of laboratory testing,and can be classified as subclinical hypothyroidism(SHypo)and subclinical hyperthyroidism(SHyper).The present paper focuses on the endogenous SHypo and SHyper in non-elderly adults.According to the several recent clinical practice guidelines,the non-gestational management and the gestational management of SHypo and SHyper are emphasized,respectively.The management recommendations in this article are only for non-elderly patients(SHypo patients younger than 70 years and SHyper ones younger than 65 years).To date,there is still a lack of well-designed large-scale prospective randomized controlled trials to evaluate the treatment of subclinical thyroid dysfunction,which is worthy of attention.