青少年甲状腺疾病的特点和管理

Characteristics and management of adolescent thyroid diseases.

青少年甲状腺疾病有其自身的特点,比如甲状腺亢进和甲状腺减退的药物选择、药物剂量、疗程等均与成人不同。药物治疗是青少年甲亢最主要的手段,手术和放疗需要严格掌握适应证。青少年甲状腺相关眼病的病情较轻,常常不需要激素等免疫抑制剂的治疗。青少年甲状腺结节中甲状腺癌的检出率高于成人,青少年分化型甲状腺癌TSH抑制治疗的目标值可以更低。对青少年甲状腺疾病的治疗,需从安全性、适宜性、有效性、依从性、可及性、经济性等多个方面加以权衡,与此同时各类疾病的随访指标和随访间期都不相同,需要针对性管理,以减少对其生长发育的不良影响。在文中,我们将对几种青少年甲状腺疾病的特点和管理做一概述。

Adolescent thyroid diseases have their own characteristics,such as the drug selection,drug dose,course of treatment for hyperthyroidism and hypothyroidism are different from adults.Drug therapy is the most important means of adolescent hyperthyroidism,and the indications for surgery and radiotherapy should be strictly controlled.Thyroidassociated ophthalmopathy in adolescents is relatively mild and often does not require immunosuppressive therapy such as glucocorticoids.The detection rate of thyroid cancer in adolescent thyroid nodules is higher than that in adults,and the target of TSH inhibition therapy for adolescent differentiated thyroid cancer may be even lower.The treatment for adolescent thyroid diseases should be balanced based on safety,suitability,effectiveness,compliance,accessibility,economy and other aspects.Meanwhile,the follow-up indicators and follow-up periods of various diseases are different,so targeted management is needed to reduce the adverse effects on their growth and development.In this paper,we will summarize the characteristics and management of several thyroid diseases in adolescents.