中国老年人甲状腺疾病诊疗专家共识(2021)

Expert Consensus on Diagnosis and Treatment for Elderly with Thyroid Diseases in China(2021)

为了提高我国老年人甲状腺疾病的临床诊疗水平,促进健康老龄化,中华医学会老年医学分会老年内分泌代谢疾病学组、中华医学会内分泌学分会甲状腺学组联合制定了《中国老年人甲状腺疾病诊疗专家共识》(简称《共识》)。《共识》包括5个部分,针对老年人甲状腺疾病诊疗中的主要临床问题作出40条推荐意见。《共识》强调临床上需关注老年人下丘脑-垂体-甲状腺轴的增龄变化;推荐采用老年综合评估方法,全面评估老年人甲状腺疾病及其干预方法对整体健康状态的影响;推荐老年人在入住养老院、住院、常规健康体检时筛查甲状腺功能减退症;制定了老年人甲状腺功能亢进症、甲状腺功能减退症、甲状腺结节和分化型甲状腺癌有别于非老年人的个体化分层管理,包括治疗方案的选择和控制目标以及诊治流程图。《共识》将为老年医学科、内分泌与代谢病科和全科医生对老年人甲状腺疾病的诊疗决策与健康管理提供依据。

In order to improve the diagnosis and treatment of senile thyroid diseases in China and to promote healthy aging,the Endocrine Metabolic Diseases Group of Chinese Geriatrics Society,and the Thyroid Group of the Chinese Society of Endocrinology of Chinese Medical Association jointly drafted the"Expert Consensus on Diagnosis and Treatment for Elderly with Thyroid Diseases in China(2021)"(referred as Consensus).The Consensus consists of five sections that set 40 recommendations on main clinical issues.The Consensus emphasizes clinical focus on the age-related changes of the hypothalamus-pituitary-thyroid axis in the elderly,and it recommends application of comprehensive geriatric assessment to thoroughly evaluate the impact of thyroid diseases and relevant intervention on overall health condition.Meanwhile,it recommends generalization of screening for hypothyroidism during admission to nursing institution or hospital,and routine health check-ups.Furthermore,it develops individualized stratified management on senile hyperthyroidism,hypothyroidism,thyroid nodules and differentiated thyroid cancer distinguished from the youngers,including treatment selection,control targets and flow charts for diagnosis and treatment.The Consensus will provide the basis for clinical decisions and health management of senile thyroid diseases by geriatricians,endocrinologists and general practitioners.