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Vitamin D,selenium,and antidiabetic drugs in the treatment of type 2 diabetes mellitus with Hashimoto's thyroiditis 被引量:2
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作者 Fen Feng Bin Zhou +3 位作者 Ci-La Zhou Ping Huang Gang Wang Kuang Yao 《World Journal of Diabetes》 SCIE 2024年第2期209-219,共11页
BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis... BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels. 展开更多
关键词 Type-2 diabetes mellitus Hashimoto's thyroiditis Vitamin D Selenium agent Hypoglycemic drugs Curative effect
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DNA Methylation of KLRC1 and KLRC3 in Autoimmune Thyroiditis:Perspective of Different Water Iodine Exposure
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作者 Yao Chen Jinjin Liu +6 位作者 Mengying Qu Bingxuan Ren Huaiyong Wu Li Zhang Zheng Zhou Lixiang Liu Hongmei Shen 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2024年第9期1044-1055,共12页
Objective This study aimed to identify differentially methylated genes(DMGs) associated with natural killer cells in patients with autoimmune thyroiditis(AIT), focusing on the influence of varying water iodine exposur... Objective This study aimed to identify differentially methylated genes(DMGs) associated with natural killer cells in patients with autoimmune thyroiditis(AIT), focusing on the influence of varying water iodine exposure levels.Methods Participants were divided into categories based on median water iodine(MWI)concentrations: iodine-fortified areas(IFA, MWI < 10 μg/L), iodine-adequate areas(IAA, 40 ≤ MWI ≤ 100μg/L), and iodine-excessive areas(IEA, MWI > 300 μg/L). A total of 176 matched AIT cases and controls were recruited and divided into 89, 40, and 47 pairs for IFA, IAA, and IEA, respectively. DMGs were identified using 850K Bead Chip analysis for 10/10 paired samples. Validation of DNA methylation and m RNA expression levels of the DMGs was conducted using Methyl Target^(TM) and QRT-PCR for 176/176paired samples.Results KLRC1, KLRC3, and SH2D1B were identified as significant DMGs. Validation revealed that KLRC1 was hypomethylated and highly expressed, whereas KLRC3 was hypermethylated and highly expressed in individuals with AIT. Furthermore, KLRC1 was hypomethylated and highly expressed in both IFA and IEA.Conclusion The DNA methylation status of KLRC1 and KLRC3 may play crucial roles in AIT pathogenesis. Additionally, DNA methylation of KLRC1 seems to be influenced by different iodine concentrations in water. 展开更多
关键词 Autoimmune thyroiditis DNA methylation KLRC1 KLRC3 SH2D1B IODINE
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Exploring the relationship between Hashimoto's thyroiditis and male fertility:A meta-analytic and meta-regression perspective on hormonal and seminal factors
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作者 Seyed Sobhan Bahreiny Mojtaba Aghaei +1 位作者 Mahdi Amraei Mohammad Reza Dabbagh 《Asian pacific Journal of Reproduction》 CAS 2024年第4期147-159,共13页
Objective:To explore the relationship between Hashimoto's autoimmune hypothyroidism(HT)and male fertility,focusing on hormonal and seminal factors.Methods:A systematic literature search was conducted across databa... Objective:To explore the relationship between Hashimoto's autoimmune hypothyroidism(HT)and male fertility,focusing on hormonal and seminal factors.Methods:A systematic literature search was conducted across databases such as PubMed,Web of Science,EMBASE,Scopus,Cochrane,and Google Scholar,covering studies published from January 2000 to March 2024.Studies investigating the impact of HT on semen quality parameters and reproductive hormones were included.Pooled effect estimates were calculated using standard mean difference(SMD)and 95%confidence intervals(CI).Results:A total of 8 studies with 8965 participants were included.HT significantly affected semen quality and reproductive hormone levels.Specifically,there was a notable decrease in progressive morphology(SMD=-0.78;95%CI:-1.40 to-0.17;P=0.01)and sperm motility(SMD=-1.151;95%CI:-1.876 to-0.425;P=0.002).In addition,there were no significant changes in reproductive hormones,although there were elevated levels of luteinizing hormone(SMD=0.437;95%CI:0.000 to 0.874;P=0.050)and follicle-stimulating hormone(SMD=0.293;95%CI:-0.171 to 0.758;P=0.216),with a slight impact on testosterone levels(SMD=-1.143;95%CI:-2.487 to 0.200;P=0.095).Conclusions:This systematic review and meta-analysis provides robust evidence of the detrimental effects of HT on semen quality and reproductive hormones,underscoring the necessity for thorough evaluation and management of thyroid function in male infertility assessments. 展开更多
关键词 Hashimoto thyroiditis Male fertility Semen quality Reproductive hormones META-ANALYSIS META-REGRESSION
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Vitamin D and selenium for type 2 diabetes mellitus with Hashimoto’s thyroiditis:Dosage and duration insights
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作者 Yun-Feng Yu Xue-Li Shangguan +2 位作者 Dan-Ni Tan Li-Na Qin Rong Yu 《World Journal of Diabetes》 SCIE 2024年第8期1824-1828,共5页
This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for typ... This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus(T2DM)patients with Hashimoto’s thyroiditis(HT)remains controversial.In the retrospective study we discuss herein,the authors highlighted significant improvements in thyroid function,thyroid antibodies,blood glucose,and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens,underscoring the value of these supplements.Our team is currently engaged in research exploring the relationship between micronutrients and HT,and we have obtained invaluable insights from the aforementioned study.Based on this research and current literature,we recommend a regimen of 4000 IU/day of vitamin D and 100-200μg/day of selenium for over three months to six months for patients with HT,particularly for those with concurrent T2DM. 展开更多
关键词 Vitamin D SELENIUM Type 2 diabetes mellitus Hashimoto’s thyroiditis DOSAGE DURATION
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Vitamin D, selenium in type 2 diabetes and Hashimoto's thyroiditis: Is it effective?
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作者 Kotha Sugunakar Reddy Vishakha Jain +1 位作者 Sakthivadivel Varatharajan Janardhana Reddy Pallavali 《World Journal of Diabetes》 SCIE 2024年第5期1048-1050,共3页
The study by Feng et al,explores treatment approaches for these coexisting conditions.It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selecti... The study by Feng et al,explores treatment approaches for these coexisting conditions.It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selection concerns.Findings indicate a complex interplay between interventions and disease markers,prompting the need for further research.Despite limitations,the study offers valuable insights into managing the intricate relationship between type 2 diabetes mellitus and Hashimoto's thyroiditis.The authors'contributions shed light on potential treatment avenues,although careful consideration of study design and patient characteristics is warranted for future investigations in this domain. 展开更多
关键词 Vitamin D SELENIUM Type 2 diabetes Mellitus Hashimoto’s thyroiditis
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Two Case Studies of Painless Thyroiditis with Special Presentation
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作者 Yanan Zhang Zhaoshun Jiang 《Proceedings of Anticancer Research》 2024年第3期97-103,共7页
This article reports two cases of painless thyroiditis with special manifestations. Patient 1 was a 76-year-old female patient who presented with palpitations and chest tightness and was diagnosed with hyperthyroidism... This article reports two cases of painless thyroiditis with special manifestations. Patient 1 was a 76-year-old female patient who presented with palpitations and chest tightness and was diagnosed with hyperthyroidism by thyroid ultrasound and electrocardiogram, which is a painless thyroiditis with atrial fibrillation as the first symptom. Patient 2 is a 44-year-old male patient, with only palpitations, diagnosed as T3 thyroiditis by liver function and thyroid function tests, and accompanied by abnormal liver function, belonging to the painless thyroiditis with elevated FT3 only. This article points out that painless thyroiditis has multiple manifestations and is easily misdiagnosed as other diseases. Therefore, patients with symptoms such as palpitations and chest tightness should undergo cytologic or pathologic examination in time to avoid missed diagnosis and misdiagnosis. 展开更多
关键词 Painless thyroiditis Atrial fibrillation Elevated FT3
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Effect of Hashimoto’s Thyroiditis on Efficacy of 131I Ablation Therapy in Intermediate- and High-Risk of Thyroid Papillary Carcinoma
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作者 Lu Zhou Gang Cheng 《Journal of Biosciences and Medicines》 2023年第4期103-113,共11页
Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients... Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients. The findings will help to develop a personalized treatment plan for patients with thyroid papillary carcinoma complicated with Hashimoto’s thyroiditis. Material and Methods: From January 2016 to December 2020, patients who were diagnosed with intermediate- and high-risk PTC with lymph node metastasis were analyzed retrospectively, excluding patients with incomplete clinical data, distant metastasis, positive TGAb, TSH Results: A total of 525 patients (166 males and 359 females) were included in the study, including 368 patients in ER group (70.1%) and 157 patients in NER group (29.9%). Eleven factors including combining Hashimoto’s thyroiditis, pre-ablative Tg levels, sex, tumor diameter, extraglandular invasion, multifocal, bilateral lesions, central lymph node metastasis, lateral lymph node metastasis, lymph node metastasis rate, thyroglobulin were statistically different between ER group and NER group with significance at P Conclusion: Hashimoto’s thyroiditis, Ps-Tg level and lateral lymph node metastasis are potential predictors for short-term efficacy of <sup>131</sup>I treatment in intermediate- and high-risk thyroid papillary carcinoma. Hashimoto’s thyroiditis, high Ps-Tg level and increased number of lateral lymph node metastasis reduce the efficacy of <sup>131</sup>I therapy in patients with intermediate and high risk thyroid papillary carcinoma. 展开更多
关键词 Papillary Thyroid Carcinoma Hashimoto’s thyroiditis 131I Therapy Curative Effect
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Gallbladder Carcinoma of the Thyroid Revealed by an Acute Festered Thyroiditis: A Literature Study about a Case
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作者 Aliou Faty Hady Tall +3 位作者 Abdou Sy Fulgence Abdou Faye Birame Loum Kevin Dimitri Manfoumbi Manfoumbi 《International Journal of Otolaryngology and Head & Neck Surgery》 2023年第3期135-139,共5页
The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a nec... The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a necrotic ulcer wound on the skin lasting 3 weeks amid a big neglected hetero-multinodular goitre, evolving since 20 years. The anatomopathological test showed a gallbladder thyroid carcinoma of the thyroid with severe inflammation. The treatment consisted of a complete thyroidectomy with recurrent bilateral dredging. There was a favourable evolution. Gallbladder carcinoma, in its aggressive aspect, may be linked to the occurrence of acute festered thyroiditis. Therefore, the prognosis of our patient was favourable. 展开更多
关键词 thyroiditis Gallbladder Carcinoma SUPPURATION
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Doctor Song Fuyin's Experience in Treating Hashimoto's Thyroiditis Based on Qi,Blood Essence and Spirit Syndrome Differentiation Stage Classification
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作者 李晓红 宋福印 庄扬名 《World Journal of Integrated Traditional and Western Medicine》 2023年第2期53-60,共8页
The paper systematically summarizes the experience of Director Song Fuyin in treating Hashimoto's thyroiditis which is a typical emotional disease that causes obvious changes in organ morphology and endocrine and ... The paper systematically summarizes the experience of Director Song Fuyin in treating Hashimoto's thyroiditis which is a typical emotional disease that causes obvious changes in organ morphology and endocrine and body fluid metabolism.It belongs to the category of psychosomatic diseases,and is the embodiment of a series of pathogenesis processes of qi disease,blood disease,essence disease and deformation in TCM theory.The whole course of the disease is dominated by the dialectical relationship of mutual influence,mutual control,mutual root and mutual use among the deity disease,qi disease,blood disease,essence and spiritual disease.Therefore,the treatment emphasizes the dialectical relationship based on qi,blood,essence and spirit.At the beginning,the treatment focuses on regulating qi and clearing heat and eliminating phlegm;at the middle stage,the treatment focuses on replenishing essence and promoting yang and eliminating wind and calming the deity;at the late stage,the treatment focuses on replenishing qi and eliminating phlegm and promoting collages.Flexible use of calming the spirits,regulating qi,dispersing essence,eliminating phlegm,promoting blood and other methods of stage classification treatment,can be targeted,improve the cure rate of the disease.This article aims to clarify the experience of Director Song Fuyin in treating Hashimoto's thyroiditis based on syndrome differentiation of qi,blood essence and spirit. 展开更多
关键词 Hashimoto's thyroiditis Song Fuyin Differentiation of qi blood essence and spirit.Experience of famous doctors Regulating qi and clearing heat Nourishing essence and enhancing yang Quenching the wind and calming the spirit Eliminating phlegm and clearing collaterals
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适碘地区老年人甲状腺结节的患病率及危险因素调查 被引量:1
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作者 张丽娜 倪文婧 +6 位作者 张梦杰 密玮诺 孙宇 李兴佳 陈国芳 刘超 徐书杭 《重庆医科大学学报》 CAS CSCD 北大核心 2024年第1期24-30,共7页
目的:调查江苏适碘地区农村老年人群甲状腺结节和甲状腺癌的患病率,并分析甲状腺结节患病的危险因素。方法:采用整群抽样的方法对江苏适碘地区进行横断面调查研究,选取2 590例60岁及以上的常驻居民进行体检与生化检查,采用甲状腺影像学... 目的:调查江苏适碘地区农村老年人群甲状腺结节和甲状腺癌的患病率,并分析甲状腺结节患病的危险因素。方法:采用整群抽样的方法对江苏适碘地区进行横断面调查研究,选取2 590例60岁及以上的常驻居民进行体检与生化检查,采用甲状腺影像学报告及数据系统(Thyroid Imaging Reporting And Data System,TI-RADS)分类方法对甲状腺结节进行分类评估,并对部分甲状腺结节进行超声引导下活检病理检查,采用Logistic回归分析甲状腺结节的危险因素。结果:2 590例受者中共检出甲状腺结节883例,总体患病率为34.09%(883/2 590),女性患病率明显高于男性(χ^(2)=27.885,P=0.000),有甲状腺结节组和无甲状腺结节组相比,身高、体质指数、空腹血糖、糖化血红蛋白、空腹胰岛素、甘油三酯、25羟维生素D差异有统计学意义(分别为t=5.337、P=0.000,t=-5.160、P=0.000,t=-2.341、P=0.019,t=-4.993、P=0.000,t=-2.384、P=0.020,t=-2.940、P=0.003,t=6.432,P=0.000)。男性甲状腺结节的患病率随年龄的增加而增加。老年人甲状腺癌的总体检出率为0.34%。Logistic回归分析结果显示,体质指数和糖化血红蛋白是甲状腺结节患病的危险因素(OR=1.054,95%CI=1.028~1.081,P<0.01;OR=1.257,95%CI=1.117~1.414,P<0.01)。结论:甲状腺结节是老年人常见的甲状腺疾病,但甲状腺癌的患病率总体较低。糖脂代谢紊乱与甲状腺结节的患病密切相关。 展开更多
关键词 甲状腺结节 甲状腺癌 流行病学 老年人
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海藻玉壶汤治疗桥本甲状腺炎临床研究 被引量:3
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作者 田林涛 王新梅 +2 位作者 郭笑丹 雷烨 魏文静 《山东中医杂志》 2024年第1期41-46,92,共7页
目的:探讨海藻玉壶汤对桥本甲状腺炎疗效及对甲状腺自身免疫性抗体、Th1/Th2相关细胞因子的影响。方法:将94例桥本甲状腺炎患者按随机数字表法分为观察组和对照组各47例。对照组患者服用硒酵母片和左旋甲状腺素钠片进行治疗,观察组在此... 目的:探讨海藻玉壶汤对桥本甲状腺炎疗效及对甲状腺自身免疫性抗体、Th1/Th2相关细胞因子的影响。方法:将94例桥本甲状腺炎患者按随机数字表法分为观察组和对照组各47例。对照组患者服用硒酵母片和左旋甲状腺素钠片进行治疗,观察组在此基础上服用海藻玉壶汤,两组疗程均为3个月。比较两组中医症状积分、治疗总有效率,以及甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPO-Ab)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、白细胞介素-10(IL-10)、白细胞介素-12(IL-12)、γ干扰素(IFN-γ)水平,并观察不良反应情况。结果:治疗后两组甲状腺肿大、咽部异物感、胸闷胁痛、乏力评分,以及血清TGAb、TPO-Ab、TSH、IL-12、IFN-γ水平均较治疗前降低,且观察组低于对照组(均P<0.05);两组血清FT3、FT4、IL-10水平均较治疗前升高,且观察组高于对照组(均P<0.05);观察组治疗总有效率95.74%,对照组82.98%,观察组疗效优于对照组(P<0.05);两组均未出现不良反应事件。结论:海藻玉壶汤联合常规西药治疗桥本甲状腺炎疗效较好,可降低甲状腺自身抗体水平并恢复甲状腺功能,其机制可能是通过下调Th1型细胞因子、上调Th2型细胞因子以改善甲状腺功能。 展开更多
关键词 桥本甲状腺炎 海藻玉壶汤 甲状腺自身免疫性抗体 甲状腺激素 TH1/TH2细胞因子
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甲状腺结节超声恶性危险分层指南对甲状腺乳头状癌的诊断价值:C-TIRADS与ATA指南比较 被引量:3
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作者 吴秀艳 蔡雪珍 +1 位作者 刘舜辉 田猛 《中国医学影像学杂志》 CSCD 北大核心 2024年第1期34-41,共8页
目的探讨甲状腺结节超声恶性危险分层中国指南(C-TIRADS)和美国甲状腺协会(ATA)指南对甲状腺乳头状癌(PTC)的诊断价值。资料与方法回顾性收集2019年7月—2021年5月联勤保障部队第九〇九医院甲状腺结节术后且有明确病理结果的259例患者(... 目的探讨甲状腺结节超声恶性危险分层中国指南(C-TIRADS)和美国甲状腺协会(ATA)指南对甲状腺乳头状癌(PTC)的诊断价值。资料与方法回顾性收集2019年7月—2021年5月联勤保障部队第九〇九医院甲状腺结节术后且有明确病理结果的259例患者(339个结节),分为甲状腺良性结节组150例(210个结节)和PTC组109例(129个结节),分析两组一般资料和结节声像图特征,分别用两种指南对结节进行分类并与手术病理结果进行对照,绘制受试者工作特征曲线评价两种指南对PTC的诊断价值。结果两组恶性声像图特征中,实性、边缘模糊/不规则或甲状腺外侵犯、垂直位、低或极低回声、微钙化差异有统计学意义(χ^(2)=123.67、132.71、103.82、4.58、137.93,P均<0.05),以PTC组多见;与C-TIRADS不同,ATA指南对61个结节(61/339,17.99%)分类不明确;C-TIRADS和ATA指南的曲线下面积分别为0.952(0.924~0.972)、0.942(0.911~0.964),差异无统计学意义(Z=0.943,P=0.346);两者的最佳截断值为4b类和高度可疑,C-TIRADS的敏感度最高[0.930(120/129)比0.822(106/129)],ATA指南的特异度最高[0.857(180/210)比0.943(198/210)],差异均有统计学意义(χ^(2)=6.99、8.57,P均<0.01),两组准确度[0.885(300/339)比0.897(300/339)]差异无统计学意义(χ^(2)=0.24,P=0.622)。结论C-TIRADS和ATA指南对PTC均有很高的诊断效能,但C-TIRADS适用于所有甲状腺结节的声像图表现,且受超声医师临床经验影响小,更易在临床推广使用。 展开更多
关键词 甲状腺癌 乳头状 甲状腺结节 超声检查 恶性风险 指南
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血清降钙素在甲状腺髓样癌的诊断、术前评估及术后随访中的临床价值 被引量:2
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作者 李婷婷 马丙娥 +3 位作者 黄驰 徐书杭 武心萍 王建华 《中国耳鼻咽喉头颈外科》 CSCD 2024年第1期7-12,共6页
目的探讨血清降钙素(calcitonin,Ctn)对甲状腺髓样癌(medullary thyroid carcinoma,MTC)的诊断效能,术前Ctn与临床病理特征相关性及随访中影响MTC疾病进展的危险因素。方法系统性回顾2011年11月~2022年11月南京中医药大学附属中西医结... 目的探讨血清降钙素(calcitonin,Ctn)对甲状腺髓样癌(medullary thyroid carcinoma,MTC)的诊断效能,术前Ctn与临床病理特征相关性及随访中影响MTC疾病进展的危险因素。方法系统性回顾2011年11月~2022年11月南京中医药大学附属中西医结合医院收治的50例甲状腺结节患者临床资料,ROC曲线计算Ctn、癌胚抗原(carcinoembryonic antigen,CEA)水平对MTC的诊断效能,单因素、多因素分析MTC中央区淋巴结转移的危险因素,绘制无疾病进展生存曲线预测危险因素。结果ROC曲线结果显示诊断MTC的术前Ctn截断值为23.81 pg/ml,CEA截断值为3.035 ng/ml。MTC患者的患病年龄、肿瘤直径、术前血清Ctn和CEA水平均高于非MTC患者。Ctn≥289.62 pg/ml是MTC患者中央区淋巴结转移的独立危险因素。生存曲线结果显示侵犯包膜、中央区淋巴结转移、T2级以上是预测疾病进展的危险因素(P<0.05),疾病发生进展的MTC患者术前Ctn较高。结论血清Ctn在MTC鉴别诊断、术前评估以及术后随访均有重要临床价值。 展开更多
关键词 甲状腺肿瘤 降钙素 癌胚抗原 诊断 甲状腺髓样癌 淋巴结转移
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中国《CACA甲状腺癌诊治指南(2022版)》外科视角解读 被引量:3
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作者 彭颖 程若川 《西安交通大学学报(医学版)》 CSCD 北大核心 2024年第1期28-34,共7页
外科手术切除是大多数甲状腺癌(thyroid cancer,TC)患者的标准治疗方法,对TC的预后具有至关重要的意义。而明确TC的手术适应证,规范TC的手术方法并制定合理化、个性化的治疗策略,是外科治疗达到疗效最大化的关键。近年来全球范围内针对T... 外科手术切除是大多数甲状腺癌(thyroid cancer,TC)患者的标准治疗方法,对TC的预后具有至关重要的意义。而明确TC的手术适应证,规范TC的手术方法并制定合理化、个性化的治疗策略,是外科治疗达到疗效最大化的关键。近年来全球范围内针对TC诊疗相关的指南共识相继迅速更新,亟需与时俱进、覆盖疾病全程、适合中国国情的综合性指南。在此背景下,中国抗癌协会(CACA)首部涵盖所有病理类型的TC诊治指南《中国肿瘤整合诊治指南-CACA甲状腺癌诊治指南》(简称2022版CACA指南)于2022年4月正式发布。本文结合笔者个人临床经验,以外科视角从分化型TC(DTC)的诊断、初始治疗和术后随访三个方面对2022版CACA指南内容进行解读,探讨外科治疗策略在TC诊治全程管理中的特殊性及其价值,并指出了未来仍需探索研究的相关领域。 展开更多
关键词 CACA甲状腺癌诊治指南 甲状腺癌 指南解读 外科手术策略
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颈部挫伤并发甲状腺上动脉破裂致咽喉后壁血肿1例
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作者 魏斌宏 张敏春 +2 位作者 孙艳萍 贺介甫 魏超 《中国耳鼻咽喉头颈外科》 CSCD 2024年第6期405-406,共2页
1临床资料患者,男,65岁,因“颈部闭合性损伤1 h”急诊收治入院,就诊时呈渐近性呼吸困难加重,伴有咽痛明显,无明显声嘶发作。查体:颈部肿胀明显,皮下有少许淤血样改变,颈部皮肤完整。3~4度阻塞性呼吸困难,不能平卧位。相关科室除外颅脑... 1临床资料患者,男,65岁,因“颈部闭合性损伤1 h”急诊收治入院,就诊时呈渐近性呼吸困难加重,伴有咽痛明显,无明显声嘶发作。查体:颈部肿胀明显,皮下有少许淤血样改变,颈部皮肤完整。3~4度阻塞性呼吸困难,不能平卧位。相关科室除外颅脑、胸腹并发伤后,急诊坐位下行气管切开术,术后呼吸有改善,但效果不明显。术前颈动脉血管造影发现左侧甲状腺上动脉破裂(图1A),颈部CT示血肿上至第2颈椎水平,下至第1胸椎水平(图1B、1C),咽喉后壁巨大血肿约500 ml,术前介入科行血管栓塞术。 展开更多
关键词 颈部损伤(Neck Injuries) 咽后壁血肿(hematoma of the posterior pharyngeal wall) 甲状腺上动脉(superior thyroid artery)
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疏肝消瘿方联合穴位敷贴治疗甲状腺结节的临床观察 被引量:1
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作者 袁加文 彭文波 +3 位作者 李馨蕊 闫丹丹 单静怡 何婧 《世界中医药》 CAS 北大核心 2024年第5期691-695,共5页
目的:探讨疏肝消瘿方联合穴位敷贴治疗甲状腺结节的效果及对甲状腺激素、血流阻力指数(RI)、搏动指数(PI)、微血管密度(MVD)影响。方法:选取2022年1月至2023年6月上海交通大学医学院附属第六人民医院收治的甲状腺结节患者80例作为研究对... 目的:探讨疏肝消瘿方联合穴位敷贴治疗甲状腺结节的效果及对甲状腺激素、血流阻力指数(RI)、搏动指数(PI)、微血管密度(MVD)影响。方法:选取2022年1月至2023年6月上海交通大学医学院附属第六人民医院收治的甲状腺结节患者80例作为研究对象,按照随机数字表法随机分为对照组与观察组,每组40例。对照组患者给予西医治疗,观察组在对照组基础上,采用疏肝消瘿方联合穴位敷贴治疗。比较2组治疗效果,包括游离三碘甲状腺素(FT3)、游离甲状腺素(FT4)及促甲状腺激素水平(TSH),以及超声指标(RI、PI、MVD)的变化情况。结果:观察组患者治疗有效率为92.50%,显著高于对照组的75.00%(P<0.05),其中医证候积分也明显低于对照组(P<0.05);2组患者治疗前后,FT3和FT4水平差异无统计学意义(P>0.05),TSH水平比治疗前下降,且观察组治疗后TSH水平降低更多(P<0.05);治疗后2组患者RI、PI、MVD值明显低于治疗前(P<0.05),且观察组RI、PI、MVD明显低于对照组(P<0.05)。结论:疏肝消瘿方联合穴位敷贴可以改善甲状腺结节患者中医证候积分,降低TSH表达水平,减少RI、PI、MVD值,效果明显。 展开更多
关键词 甲状腺结节 疏肝消瘿方 穴位敷贴 甲状腺激素 促甲状腺激素 游离甲状腺素 游离三碘甲状腺素 超声指标
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超声引导下无水乙醇联合微波序贯消融治疗对良性甲状腺囊实性结节疗效的影响因素及并发症分析 被引量:1
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作者 刘玉江 李佳 +1 位作者 徐瑞芳 钱林学 《中国临床医学影像杂志》 CAS CSCD 北大核心 2024年第4期229-233,共5页
目的:旨在探讨影响序贯消融对良性甲状腺囊实性结节疗效的相关因素,并分析该治疗方法术后并发症的发生原因。方法:回顾性分析329个接受序贯消融治疗的良性甲状腺囊实性结节。探究结节囊实性分类、囊液性质类型、术前症状评分及结节囊性... 目的:旨在探讨影响序贯消融对良性甲状腺囊实性结节疗效的相关因素,并分析该治疗方法术后并发症的发生原因。方法:回顾性分析329个接受序贯消融治疗的良性甲状腺囊实性结节。探究结节囊实性分类、囊液性质类型、术前症状评分及结节囊性部分有无分隔等对序贯消融治疗良性甲状腺囊实性结节疗效的组间差异,并分析各组间的独立影响因素。结果:结节囊实性分类、囊液性质类型等在不同疗效组间具有统计学差异;囊液性质类型是影响序贯消融良性甲状腺囊实性结节有效与否的独立影响因素;结节囊实性分类及结节囊性部分有无分隔是影响序贯消融良性甲状腺囊实性结节治疗有效者治愈与否的独立影响因素。结论:序贯消融对甲状腺囊实性结节疗效受到结节囊实性分类、囊液性质类型及囊性部分有无分隔的影响。 展开更多
关键词 甲状腺结节 超声检查
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^(99m)TcO4-SPECT/CT甲状腺核素显像联合超声及TSH对甲状腺结节性质的诊断价值 被引量:1
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作者 王静 吴龙云 +5 位作者 郝宏毅 尹彩君 杨勇 倪效波 张荣 王雪霁 《宁夏医学杂志》 CAS 2024年第3期206-209,F0002,共5页
目的通过高锝酸钠-单光子发射计算机断层显像/电子计算机X射线断层扫描技术(^(99m)TcO4-SPECT/CT)核素显像提供甲状腺结节功能状态、结节解剖特点以及超声检查联合血清促甲状腺激素(TSH)水平进一步鉴别诊断甲状腺结节的良恶性,客观评价... 目的通过高锝酸钠-单光子发射计算机断层显像/电子计算机X射线断层扫描技术(^(99m)TcO4-SPECT/CT)核素显像提供甲状腺结节功能状态、结节解剖特点以及超声检查联合血清促甲状腺激素(TSH)水平进一步鉴别诊断甲状腺结节的良恶性,客观评价甲状腺结节的良恶性情况,对甲状腺结节的良恶性做出早期诊断。方法对因甲状腺结节同时行^(99m)TcO4-SPECT/CT甲状腺核素显像、甲状腺B超及TSH水平检查的患者共80例(92个结节)进行回顾性分析,对比不同方法及联合检查对甲状腺结节的诊断效能。结果92个结节中良性74个,恶性18个;^(99m)TcO4-SPECT/CT甲状腺显像与超声检查比较灵敏度(77.8%)高,特异度(70.2%)及准确度(71.7%)低,假阳性率(29.7%)高,假阴性率(22.2%)低,两者之间灵敏度、特异度、准确度、假阳性率、假阴性率差异均具有统计学意义(P<0.05);两者准确度比较差异无统计学意义(P>0.05)。^(99)mTcO4-SPECT/CT甲状腺显像与超声检查比较灵敏度高,特异性及准确度低,假阳性率高,假阴性率低,两者之间灵敏度、特异度、准确度、假阳性率、假阴性率差异均具有统计学意义(P<0.05);两者准确度比较差异无统计学意义(P>0.05);^(99m)TcO4-SPECT/CT甲状腺显像与超声检查联合较单独核素、单独超声检查灵敏度(88.9%)、特异度(87.8%)、准确度(81.5%)高,假阳性率(12.1%)、假阴性率(11.1%)低;联合检查与单独核素特异度、准确度、假阳性率比较差异有统计学意义(P<0.05),灵敏度与假阴性率比较差异无统计学意义(P>0.05);联合检查与单独超声灵敏度、准确度、假阴性率比较差异有统计学意义(P<0.05);特异度与假阳性率比较差异无统计学意义(P>0.05)。结论超声可以作为甲状腺结节的首选检查方法,其特异性高,但灵敏度低。^(99m)TcO4-SPECT/CT甲状腺显像在提供功能和代谢信息的同时,能提供解剖信息;而血清TSH水平则可为甲状腺结节的良恶性鉴别提供重要的参考依据,尤其对于核素冷结节且超声实性结节的患者,更应参考其TSH水平,将三者结合起来判断甲状腺结节的性质,为临床提供恰当的治疗方案,这具有重要意义。 展开更多
关键词 ^(99m)TcO4-SPECT/CT甲状腺核素显像 超声 血清促甲状腺激素 甲状腺结节
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超声人工智能辅助诊断系统用于甲状腺髓样癌 被引量:1
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作者 江柳 陈蕾 +5 位作者 张晓婷 刘畅 梁振威 孙秀明 邵玉红 陈路增 《中国医学影像技术》 CSCD 北大核心 2024年第2期208-211,共4页
目的 以甲状腺乳头状癌(PTC)为对照,对比超声甲状腺人工智能(AI)辅助诊断系统(AI辅助诊断系统)与不同年资超声医师诊断甲状腺髓样癌(MTC)的效果。方法 纳入经病理证实的63枚MTC、70枚PTC和62枚良性结节。以AI辅助诊断系统分析并识别结节... 目的 以甲状腺乳头状癌(PTC)为对照,对比超声甲状腺人工智能(AI)辅助诊断系统(AI辅助诊断系统)与不同年资超声医师诊断甲状腺髓样癌(MTC)的效果。方法 纳入经病理证实的63枚MTC、70枚PTC和62枚良性结节。以AI辅助诊断系统分析并识别结节,将恶性概率值≥0.40者诊断为恶性结节;由高、中及初级职称医师各1名利用我国甲状腺影像报告和数据系统(C-TIRADS)对甲状腺结节进行分类;对比两种方法诊断MTC及PTC的效能。结果 AI辅助诊断系统诊断MTC和PTC的敏感度、特异度、阳性预测值、阴性预测值、准确率及曲线下面积(AUC)均低于3名医师;高、中级职称医师与AI辅助诊断系统诊断MTC和PTC的AUC差异均有统计学意义(P均<0.01),初级职称医师与AI辅助诊断系统AUC差异均无统计学意义(P均>0.05)。AI辅助诊断系统诊断MTC的敏感度、特异度、阳性预测值、阴性预测值、准确率及AUC均低于其诊断PTC,但AUC差异无统计学意义(P>0.05)。结论 超声甲状腺AI辅助诊断系统诊断MTC效能较高。 展开更多
关键词 甲状腺肿瘤 髓样 超声检查 人工智能
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扶正化浊汤联合甲状腺片治疗对甲状腺结节大小及疗效的影响 被引量:1
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作者 韩娟 张立文 +4 位作者 宋金岭 董进 李海华 赵辉 左艳敏 《贵州医科大学学报》 CAS 2024年第3期463-468,共6页
目的探讨扶正化浊汤治疗甲状腺结节(TN)对结节大小的影响。方法TN患者106例,随机均分为观察组和对照组,对照组给予左甲状腺素钠片常规治疗,观察组在对照组基础上同时增加扶正化浊汤治疗;于治疗前、治疗3个月时,对2组患者进行中医主症评... 目的探讨扶正化浊汤治疗甲状腺结节(TN)对结节大小的影响。方法TN患者106例,随机均分为观察组和对照组,对照组给予左甲状腺素钠片常规治疗,观察组在对照组基础上同时增加扶正化浊汤治疗;于治疗前、治疗3个月时,对2组患者进行中医主症评分,采用彩色多普勒超声仪记录2组患者结节数目、最大直径、结节体积、血流阻力指数(RI)及搏动指数(PI),同时采集患者外周静脉血4 mL,检测促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲腺原氨酸(FT4)及血管内皮生长因子(VEGF)水平,治疗3个月后评估2组患者的西医疗效,记录2组治疗期间恶心、呕吐、皮疹及口干等不良反应发生情况。结果治疗后3个月,2组中医主症评分均较治疗前下降,且观察组低于对照组(P<0.05);与对照组比较,2组TN患者治疗3个月后结节数目减少、结节最大直径和结节体积均降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后3个月,观察组TSH低于对照组,FT 3、FT 4高于对照组(P<0.05);治疗3个月后,观察组VEGF、RI、PI低于对照组(P<0.05);观察组西医疗效和中医证候疗效中的临床痊愈和总有效率均高于对照组,差异有统计学意义(P<0.05);比较观察组与对照组不良反应发生率比较,差异无统计学意义(P>0.05)。结论扶正化浊汤治疗TN疗效显著,可有效减轻患者症状,减小结节数目及大小,调节甲状腺功能,改善血流状况,降低VEGF表达,且安全性高。 展开更多
关键词 甲状腺结节 扶正化浊汤 疗效 结节大小 甲状腺功能 血管内皮生长因子水平
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