亚临床甲状腺功能减退症的筛查

Screening for Subclin ical Hypothyroidism.

目的:观察本科甲状腺疾病患者中亚临床甲状腺功能减退症(甲减)的发病情况,分析其病因及临床特点。方法:选取2002年9～12月本科甲状腺疾病患者血清2009份,采用化学发光免疫分析法检测促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)。亚临床甲减以TSH>4.5mU/L且FT3、FT4在正常值范围为诊断标准。结果:①本科甲状腺疾病患者中检出亚临床甲减123例,检出率为6.12%,其中男性5.73%,女性6.26%;②病因:甲状腺炎患者占53.7%,医源性甲减者占46.3%;③临床特点:有不适主诉者占66.7%,有血脂异常或传导阻滞或心包积液者占30.9%,其中≥55岁占71.1%。结论:亚临床甲减是一组异质性疾病,甲状腺炎是最常见的病因,医源性因素次之,临床表现类似甲减,可有心血管系统、神经精神系统及脂质代谢的异常。

Objective:To study the occurence of subclinical hypothyroidism among patie nt s with thyroid diseases in our depart-ment of endocrinology,and evaluate its et iology and clinical feature.Methods:From Sep2002through Dec2002,thyroid stimulat ing hormone(TSH)and free thyroxine(FT 3 and FT 4 )were detected in2009serum specimens by chemilumino-im-munoassay.Subclinic al hypothyroidism was diagnosed by an elevated level of TSH(>4.5mU/L)with normal range of FT 3 and FT 4 concentration.Results:①The occurence of subclinical hypothyrodism was6.12%i n patients with thyroid dis-eases,and was5.73%and6.26%among males and females,r espectively.②Etiological analysis showed that thyroiditis and iatrogenic hypoth yrodism were53.7%and46.3%,respectively.③There were66.7%patients complained of d iscom-forts(66.7%),dyslipidemia,heart block or pericardiac effusion were30.9%an d71.1%of patients were older than55years.Conclusions:Subclinical hypothyroidism is a heterogeneous disorder.Thyroiditis and iatrogenic factors are its the most common causes.Its clinical feature is similar to hypothyroidism,including disord ers of cardiovascular,mental and nervous system,and lipids metabolism.