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无痛性甲状腺炎
引用本文:高莹,高燕明. 无痛性甲状腺炎[J]. 国际内分泌代谢杂志, 2009, 29(6). DOI: 10.3760/cma.j.issn.1673-4157.2009.06.019
作者姓名:高莹  高燕明
作者单位:北京大学第一医院内分泌科,100034;北京大学第一医院内分泌科,100034
摘    要:无痛性甲状腺炎是一种自身免疫性甲状腺炎,表现为短暂、可逆的甲状腺滤泡破坏,局灶性淋巴细胞浸润.10%发生在产后,称之为产后甲状腺炎.甲状腺无疼痛及触痛为其特征.其典型的甲状腺功能变化类似于亚急性甲状腺炎.摄碘率、T_3/T_4比值及促甲状腺激素受体抗体(TRAb)有助于无痛性甲状腺炎与Graves病的鉴别.无痛性甲状腺炎在甲状腺毒症阶段为对症治疗,甲状腺功能减退(甲减)阶段视病情需要短期、小剂量补充甲状腺激素,而永久性甲减需终生替代治疗.甲状腺功能恢复正常后仍需继续随访.

关 键 词:无痛性甲状腺炎  甲状腺疾病

Painless thyroiditis
GAO Ying,GAO Yan-ming. Painless thyroiditis[J]. International JOurnal of Endocrinology and Metabolism, 2009, 29(6). DOI: 10.3760/cma.j.issn.1673-4157.2009.06.019
Authors:GAO Ying  GAO Yan-ming
Abstract:Painless thyroiditis appears to be autoimmune in origin,thyroid contains a lymphocytic infiltration.Postpartum thyroiditis is one special type,which occtlrs in postpartum.The characteristics of painless thyroiditis are no evidence of pain or tenderness in the thyroid.It might be helpful to discriminate painless thyroiditis and Graves'disease by using RAIU,T_3/T_4 ratio and TRAb.Symptoms of thyrotoxicosis in painless thyroiditis are treated with beta blockers.A low dose of levothyroxine therapy could be used in temporary hypothyroid phase.When hypothyroidism persists,a long-term levothyroxine therapy should be administered.Patients with painless thyroiditis should be carefully followed up.
Keywords:Painless thyroiditis  Thyroid diseases
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