原发性甲状腺功能亢进症的超声分型及其临床意义

目的探讨二维超声及彩色多普勒血流显像(CDFI)对未治疗的原发性甲状腺功能亢进症(PH)的超声分型及其临床意义。方法对59例未治疗的PH患者行二维超声及CDFI检测,同时检测甲状腺功能,并与健康对照组比较。结果PH组甲状腺体积、甲状腺上动脉血流速度均高于对照组,阻力指数低于对照组(P<0.05)。PH患者甲状腺超声声像图表现为均匀回声和不均匀回声两种类型,两型间血流、甲状腺激素水平无显著性差异(P>0.05),但不均匀回声型组甲状腺球蛋白抗体(TGAb)和/或甲状腺微粒体抗体(TMAb)水平高于均匀回声型组(P<0.05)。结论PH的超声分型对临床治疗方法的选择有重要参考价值。

The ultrasonographic characteristics of primary hyperthyroidism and its clinical value

Objective To study ultrasonic types of PH in untreated patients by using two-dimensional ultrasound,CDFI and its significance in treatment.Methods We summarized 59 cases of patients with PH and 39 healthy volunteers as a control group.The volume of thyroid gland(V)was examined by using two-dimensional ultrasound and systolic and diastolic blood flow velocity(Vmax,Vmin)and resistance index(RI)were examined by using CDFI in these two groups.Serum levels of TT3,TT4,FT3,FT4,TSH,TRH,TRAb,TGAb and TMAb were also assayed by radioimmunoassay.Results V,Vmax,and Vmin in PH group were significantly increased but RI was significantly decreased in PH group as compared with the control group(P<0.05).There were two different ultrasonic types in PH according to the ultrasonic characteristics:homogeneous echo and inhomogeneous echo.There were no significant differences in the serum levels of TT3,TT4,TSH,TRAb,V,Vmax,Vmin or RI(P>0.05),but a significant difference in the levels of TGAb and/or TMAb(P<0.05)between both types of PH.Conclusion Our study indicates that two ultrasonic types of thyroid gland may be found in patients with PH:type of homogeneous echo and type of inhomogeneous echo.The types are is important in treatment.