75例亚急性甲状腺炎的临床研究

目的：探讨亚急性甲状腺炎（SAT）的诊断治疗。方法：回顾性总结分析1990-2000年经治的75例SAT的临床资料。结果：女性发病多于男性，发病年龄30-50岁者占69.3%；全部病人均有甲状腺肿大及触痛；T3、T4增高者占62.4%；甲状腺摄^131I功能低于正常者占58.9%；甲叛变 腺核素（^99mTCO4)显像检查提示甲状腺功能低于正常者78.4%；血清T3、T4增高而甲状腺摄^131I功能低于正常者占58.9%；甲状腺核素（^99mTCO4)显像检查提示甲状腺功能低于正常者78.4%；血清TT4增高而甲状腺摄^131I率降低，呈分离现象者占53.5%;82.6%的患者经强的松治疗效果良好，结论：应重视病史询问和甲状腺触诊；核医学检查是诊断本病的重要方法；T3、T4与甲状腺摄^131I率的分离现象为SAT的特征性表现；认为甲状腺核素显像检查与吸^131I率之间有较好的平行关系；肾上腺糖皮质激素是本病最有效的治疗药物。

Subacute Thyroiditis: Clinical Analyis of 75 Cases

Objective: To investigate diagnosis and treatment of subacute thyroiditis (SAT) (thought to be due to viral infection). Methods: A retrospective study and analysis was made on clinical data of 75 SAT cases treated from 1990 to 2000. Results: More prevalence of the disease was seen in female, and 69.3% of the patients were within the age of 30 to 50 years. All had enlargement and tenderness of thyroid gland. 62.4% of them gad increase of serum T3 and T4, and 58.9% of them showed lower intake of 131 I Nuclide scintiscanning, 99mTcO4 showed hypothyroidism in 78.4%.Inconsistent phenomenon of high serum T3 and T4 with low intake of 131 I accounted for 53.5% of the patients. 82.6% of the patients had excellent results with prednisone treatment. Conclusion: 1)More attention should be paid to patient's history and palpation of the gland, that would arouse suspicion of the disease. 2)Examination with methods of nuclear medicine is important in establishing the diagnosis. Inconsistency of high serum T3 and T4 with low intake of 131 I by the gland is a phenomenon characteristic of SAT. 3) The intake rate of 131 I is parallel with the result of nuclide scintiscanning. 4)Adreno-glucocorticosteroid seems to be the most effective in treating the disease.