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目的 探讨亚急性甲状腺炎（ＳＡＴ）的病因、诊断及治疗。方法 回顾性总结分析了１９８０－１９９８年年经治的ＳＡＴ的临床资料,结果 女性多地男性多地男发病年龄３０－５０岁者占７８％;全部病从均有甲状腺肿大及触痛,１７例呈Ｔ３、Ｔ４与甲状腺摄碘率分离现象;２９例子强的松治疗,效果良好;误行手术３例,２例出现术后甲状腺 机能减退且需替代治疗。结论 确立ＳＡＴ的诊断庆重视详细询问病史,并进行必要的辅助检查,     

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亚急性甲状腺炎 ,又称DeQuervain病。就普外科医师来说 ,临床并不多见 ,因大多数采用内科治疗 ,只有极少数需手术处理。亚急性甲状腺炎是一种自限性非化脓性炎性病变 ,早在 182 5年已有描述 ,至 1895年Mygind首先报道18例 ,当时称之为急性单纯性甲状腺炎。DeQuervain 190 4年和 193 6年两次报道并详细描述了本病[1 ] 。因其不同于病程较短的急性化脓性甲状腺炎。也不同于病程较长的淋巴细胞性甲状腺炎 ,故称为亚急性甲状腺炎 ,历史上曾称本病为病毒性甲状腺炎 ,急性非化脓性甲状腺炎。巨细胞性甲状腺炎、肉芽肿性甲状腺炎、假结核性甲状腺…     

Contribution of ultrasonography in the evaluation of subacute thyroiditis

Ultrasonography is a useful tool in diagnosing and monitoring thyroid pathology. The aim of this study was to evaluate the value of thyroid ultrasonography in the follow-up of subacute thyroiditis (SAT). The study group included 48 subjects with clinical and biological diagnosis of subacute thyroiditis. All patients were evaluated by ultrasonography and followed-up for a mean period of 12 months. The evaluation protocol included biological data (TSH, T4, erythrocyte sedimentation rate--ESR) and ultrasonography, performed at 1, 2, 3, 6, and 12 months. Initially, all patients had an enlarged thyroid volume (median = 30.5 ml, range 23-90) and a low echogenicity, with an inhomogeneous aspect in 54.1% cases. After a mean period of 3 months thyroid volume had a significant reduction (median volume = 20.2 ml, range 7-36, p < 0.0001). Echogenicity was also significantly improved, with a decrement, on a semi-quantitative scale of 4 degrees (1 = normal, 4 = intense hypoechogenicity), from 3.25 to 2.48 (p < 0.0001). Almost half of the patients (45.8%) presented persistent (although slighter) hypoechoic/inhomogeneous pattern. Ultrasonographic abnormalities were not correlated with the intensity of the inflammatory syndrome and/or the thyroid status. Recurrence appeared in 10 (20.8%) patients. All patients presented a new thyroid enlargement (from a median = 16.1 ml to 31.5 ml, p = 0.056) and an extension of hypoechoic regions. The risk of recurrence could not be correlated with thyroid function, inflammatory syndrome or ultrasonographic aspect. There were not significant differences between the subgroups of patients with and without recurrence concerning the initial thyroid volume (p = 0.889), echogenicity (p = 0.735), TSH (p = 0.321) or ESR (p = 0.1332). Thyroid ultrasonography is useful not only for the initial diagnosis but also for the follow-up of patients with subacute thyroiditis. Remission and recurrence can be appreciated and monitored by the ultrasonographic pattern of the thyroid.     

Painful thyroid nodule,a misleading presentation of subacute thyroiditis

Typical presentation of subacute thyroiditis (SAT) is an anterior neck pain radiating up to the jaw and ear, often associated with asthenia and fever. Biology shows hyperthyroidism and inflammation. The thyroid uptake is low at scintigraphy. However, the clinical presentation of SAT may be misleading. We report two cases of SAT whose initial manifestation was a painful thyroid nodule suspected of malignancy. In both cases, ultrasound feature was a heterogeneous, hypoechoic, ill-defined area with a low vascularization on colour Doppler. These areas were interpreted by radiologist as nodules. Surgery was then considered. Such a presentation should be known by clinicians to prevent unnecessary surgery.     

甲亢灵治疗难治性亚急性甲状腺炎37例分析

目的:探讨甲亢灵治疗难治性亚急性甲状腺炎的临床效果及停药指征.方法:糖皮质激素治疗2周效果差的37例亚甲炎患者,给予甲亢灵口服,7片/次,3次/天;综合停药指征正常后,予以停药.结果:甲亢灵治疗,1周有效率90%以上,总有效率达100%;综合停药指征正常后停药,复发率低.结论:甲亢灵治疗亚甲炎效果好,副作用少,不当停药易致反复,推荐综合停药指征.     

慢性淋巴细胞性甲状腺炎的诊断与治疗

目的 探讨慢性淋巴细胞性甲状腺炎（CLT）的诊断，以及CLT合并其它甲状腺疾病的治疗选择。方法 对1986－1999年经治的63例CLT的临床资料进行回顾性分析。结果 经非手术诊断26例（其中11例为经细针穿刺病理学诊断），诊断率41．3％；其余37例分别误诊为其他甲状腺疾病而行手术治疗，其中合并结节性甲状腺肿2例，合并甲亢6例，合并甲状腺瘤1例，合并甲状腺癌2例，合并甲状腺恶性淋巴瘤1例。63例中19例予甲状腺素片治疗，3例未予治疗；4例服甲状腺素片后行手术治疗，37例予手术治疗。非手术治疗组均获得较满意的近期效果；而手术组中29例（78．4％）获随访1－6年，5例发生甲减。全面的血清免疫学检查，结合细钾穿刺病理检查可望提高CLT的诊断率及非手术诊断率。对可疑病例须谨防遗漏其它合并症。本病以非手术治疗为主，对合并其它病变者，根据病理学类型选择适当的手术或非手术处理方式。     

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目的 探讨辅助检查在诊断亚急性甲状腺炎中的作用。方法 回顾分析372例亚急性甲状腺炎病人所做的各项辅助检查结果。结果 血沉，B超，彩色多普勒，甲状腺核素扫描，甲状腺吸^131I率测定，细针穿刺细胞学，TMA，TGA等项检查诊断本病的阳性率分别为93.75%,81.63%,95.62%,89.66%,69.70%,89.41%,13.46%和9.62%。T3，T4，TSH检查结果随着病程的进展变化较大。结论 血沉检查对诊断本病缺乏特异性；彩色多普勒，细针穿刺细胞学检查诊断率高，特异性强，是首选的检查手段；甲状腺核素扫描可以准确地反映甲状腺功能状态；检测血清中T3，T4，TSH水平可以协助诊断本病，判断疾病所处时期。     

超声对泼尼松治疗亚急性甲状腺炎停药指标的判断价值

目的探讨二维超声结合彩色多普勒血流显像（CDFI）对亚急性甲状腺炎的诊断价值和泼尼松停用指标的判断。方法66例亚急性甲状腺炎患者应用二维超声结合CDFI效应动态观察甲状腺声像图,在使用泼尼松治疗后,随机分为超声观察停药组36例和临床症状停药组30例,观察两组复发情况。结果声像图主要表现为病灶区回声减低,CDFI示病变周边血流较丰富,病灶内动脉血流特点为低速低阻型。超声观察停药组复发率8．33％（3／36）,明显低于临床症状停药组的26．67％（8／30）,两组比较差异有统计学意义（P〈0．05）。结论二维超声结合CDFI可以诊断和指导亚急性甲状腺炎的治疗,为病情评价提供客观依据。     

慢性淋巴细胞性甲状腺炎的临床特点

慢性淋巴细胞性甲状腺炎是由Ｈａｓｈｉｍｏｔｏ于 1912年首先报告并描述的 ,又称为桥本病或桥本甲状腺炎(Ｈａｓｈｉｍｏｔｏｔｈｙｒｏｉｄｉｔｉｓ ,ＨＴ)。由于其甲状腺组织中有大量淋巴细胞浸润 ,故称之为慢性淋巴细胞性甲状腺炎。经研究表明本病属自身免疫性疾病 ,因此也称为自身免疫性甲状腺炎。ＨＴ是甲状腺炎中最常见的一种 ,以前认为ＨＴ发病率低 ,但随着诊断技术水平不断提高 ,ＨＴ的发病率迅速增加。有报告认为其发病率与甲状腺机能亢进症 (下称甲亢 )发病率相近。由于ＨＴ的临床表现有多种类型 ,除典型的类型外 ,尚有许多不典…     

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目的 探讨亚急性甲状腺炎药物治疗效果及甲状腺功能与形态变化特点。方法：对２９例病人应用超声显像法观察甲状腺的形态变化，用放免法测定甲状腺素（Ｔ３、Ｔ４）甲状腺微粒体抗体（ＴＭＡ）、甲状腺球蛋白抗体（ＴＧＡ）及促甲状腺素的变化，结果 １６例Ｔ３、Ｔ４增主贩病人，治疗后Ｔ３、Ｔ４明显下降。８例ＴＧＡ、ＴＭＡ增高的病人，治疗后ＴＧＡ、ＴＭＡ恢复正常。１８便腺体增大者，经治疗后体积恢复正常。有１例炎症消退