亚急性甲状腺炎的临床分析(1)
摘 要：目的 探讨亚急性甲状腺炎的临床特点，降低临床误诊率。方法 回顾性分析2010年1月～2015年12月亚急性甲状腺炎患者54例的临床资料。结果 54例亚急性甲状腺炎患者中，发病年龄以中、青年为主，女性多于男性；46.30%的患者在发病前有上呼吸道感染史。多数患者出现发热、甲状腺毒症症状、甲状腺区疼痛和甲状腺触痛；甲状腺肿大见于全部病例；甲状腺激素水平增高、甲状腺摄碘率减低是最显著的临床特征；门诊首诊误诊率25.90%，其中非内分泌科首诊误诊率高于内分泌专科。所有患者经非甾体药物及糖皮质激素治疗有效。结论 绝大多数亚急性甲状腺炎患者有典型的临床表现，但易误诊。详细询问病史、仔细查体、合理选择实验室检查并正确解读实验室检查结果有利于减少误诊率。非甾体类药物和糖皮质激素治疗亚急性甲状腺炎有效。
关键词：甲状腺炎，亚急性；糖皮质激素
中图分类号：R581.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.01.073
, http://www.100md.com
文章编号：1006-1959(2018)01-0181-03
Clinical Analysis of Subacute Thyroiditis
ZHONG Shi-jia
(Department of Emergency，the Sichuan Provincial Police General Hospital，Chengdu 610225，Sichuan，China)
Abstract：Objective To investigate the clinical features of subacute thyroiditis，reduce the misdiagnosis rate.Methods Retrospective analysis of clinical data from January 2010 to December 2015，54 cases of subacute thyroiditis patients.Results 54 cases of subacute thyroiditis patients，age of onset in young people，more women than men； 46.30% of the patients had history of upper respiratory tract infection before the onset.Most of the patients had fever，symptoms of thyrotoxicosis，thyroid pain and tenderness of thyroid goiter in all cases；increased the level of thyroid hormone，thyroid iodine uptake decreased is the most notable clinical characteristics；The outpatient misdiagnosis rate was 25.90%，the misdiagnosis rate is higher than the non department of endocrinology.The endocrine specialist non steroidal drugs and glucocorticoid treatment was effective in all patients. Conclusion The majority of patients with subacute thyroiditis with typical clinical manifestations，but easily misdiagnosed.Detailed history，careful physical examination，laboratory examination and examination results of reasonable choice the correct interpretation of the laboratory to reduce the misdiagnosis rate.Non steroid drugs and glucocorticoids are effective in the treatment of subacute thyroiditis.
, http://www.100md.com
Key words：Thyroiditis；Subacute；Glucocorticoid
亞急性甲状腺炎(subacute thyroiditis， SAT)是一种自限性甲状腺疾病。该病在临床上较为常见，但易发生误诊。本文采用回顾性分析的方法，分析了在四川省司法警官总医院就诊的54例亚急性甲状腺炎患者的临床资料，以提高对该病的认识，减少误诊，现分析如下。
1资料与方法
1.1 一般资料 收集2010年1月～2015年12月在我院诊治的亚急性甲状腺炎患者54例。其中男12例，女42例，男女之比1∶3.5，年龄20～62岁，平均年龄(42.8±8.9)岁。本组病例从发病到确诊时间5 d～52 d，平均时间(10.2±6.4)d。
1.2 诊断标准 依据2008年中国甲状腺疾病诊治指南[1]，要点如下：①急性起病、发热等全身症状；②甲状腺疼痛、肿大且质硬；③红细胞沉降率显著增快；④血清甲状腺激素浓度升高与甲状腺摄碘率降低的双向分离现象；⑤甲状腺核素扫描：早期甲状腺无摄取或摄取低下；⑥甲状腺细针穿刺和细胞学检查：早期典型细胞学涂片可见多核巨细胞、片状上皮样细胞、不同程度炎性细胞。符合上述4点及以上可诊断为亚急性甲状腺炎。, http://www.100md.com(钟时嘉)
关键词：甲状腺炎，亚急性；糖皮质激素
中图分类号：R581.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.01.073
, http://www.100md.com
文章编号：1006-1959(2018)01-0181-03
Clinical Analysis of Subacute Thyroiditis
ZHONG Shi-jia
(Department of Emergency，the Sichuan Provincial Police General Hospital，Chengdu 610225，Sichuan，China)
Abstract：Objective To investigate the clinical features of subacute thyroiditis，reduce the misdiagnosis rate.Methods Retrospective analysis of clinical data from January 2010 to December 2015，54 cases of subacute thyroiditis patients.Results 54 cases of subacute thyroiditis patients，age of onset in young people，more women than men； 46.30% of the patients had history of upper respiratory tract infection before the onset.Most of the patients had fever，symptoms of thyrotoxicosis，thyroid pain and tenderness of thyroid goiter in all cases；increased the level of thyroid hormone，thyroid iodine uptake decreased is the most notable clinical characteristics；The outpatient misdiagnosis rate was 25.90%，the misdiagnosis rate is higher than the non department of endocrinology.The endocrine specialist non steroidal drugs and glucocorticoid treatment was effective in all patients. Conclusion The majority of patients with subacute thyroiditis with typical clinical manifestations，but easily misdiagnosed.Detailed history，careful physical examination，laboratory examination and examination results of reasonable choice the correct interpretation of the laboratory to reduce the misdiagnosis rate.Non steroid drugs and glucocorticoids are effective in the treatment of subacute thyroiditis.
, http://www.100md.com
Key words：Thyroiditis；Subacute；Glucocorticoid
亞急性甲状腺炎(subacute thyroiditis， SAT)是一种自限性甲状腺疾病。该病在临床上较为常见，但易发生误诊。本文采用回顾性分析的方法，分析了在四川省司法警官总医院就诊的54例亚急性甲状腺炎患者的临床资料，以提高对该病的认识，减少误诊，现分析如下。
1资料与方法
1.1 一般资料 收集2010年1月～2015年12月在我院诊治的亚急性甲状腺炎患者54例。其中男12例，女42例，男女之比1∶3.5，年龄20～62岁，平均年龄(42.8±8.9)岁。本组病例从发病到确诊时间5 d～52 d，平均时间(10.2±6.4)d。
1.2 诊断标准 依据2008年中国甲状腺疾病诊治指南[1]，要点如下：①急性起病、发热等全身症状；②甲状腺疼痛、肿大且质硬；③红细胞沉降率显著增快；④血清甲状腺激素浓度升高与甲状腺摄碘率降低的双向分离现象；⑤甲状腺核素扫描：早期甲状腺无摄取或摄取低下；⑥甲状腺细针穿刺和细胞学检查：早期典型细胞学涂片可见多核巨细胞、片状上皮样细胞、不同程度炎性细胞。符合上述4点及以上可诊断为亚急性甲状腺炎。, http://www.100md.com(钟时嘉)