亚临床甲状腺功能紊乱的发病率及病因分析

目的：探讨亚临床甲状腺功能紊乱的发病率及病因。方法：对12592例本地区的门诊及住院病例的甲状腺功能检测的七项指标进行筛查分析。结果：12592例检测者中有874例TSH在异常范围内，检出率为6．94％，其中TSH高于正常者397例，检出率为3．15％，TSH低于正常者477例，检出率为3．79％；874例处于亚临床甲状腺功能紊乱者多见于伴相关甲状腺疾病者，如甲亢治疗后、甲减甲状腺制剂替代治疗中及其他甲状腺病变（甲状腺结节、甲状腺炎）。除外上述因素在无明显疾病的143人中，亚临床甲减者109人（874人中12．47％），亚临床甲亢者34人（874人中3．89％）。亚临床甲状腺功能紊乱与TGA、TMA多同步上升，升高者269例，发生率为30．78％，其中TSH高于正常者147例，占16．82％，TSH低于正常者122例，占13．96％；874例中≥60岁老年人有256例，检出率为29．29％。结论：临床应重视对亚临床甲状腺功能紊乱的检测，特别是老年人具有较高的发病率。

Study on the Incidence and Etiology of Subclinical Thyroid Function Disorders

Objective To study the incidence and etiology of subclinical thyroid function disorders in 12592 subjects tested.Methods The etiology of 874 patients with abnormal serum TSH(with IRMA) found in the tested 12592 patients,whose serum T_3,T_4,FT_3,FT_4, TSH,TGA and TMA were also detected with RIA was analyzed.Results 874 of 12592 patients had abnormal TSH levels(6.94%).Among them,TSH was elevated in 397 patients(3.15%) and decreased in 477 patients(3.79%).Most of them were associated with obvious related thyroid or other thronic diseases such as hyperthyroidism after therapy,thyroxine replacement treatment of hypothyroidism and other thyroid diseases(thyroiditis,diffuse nontoxic goiter).In the remaining apparently disease-free 143subjects,there were with subclinical hypothyroidism and 34(3.89% of 874) with subclinical hyperthyroidism.Also among the 874 patients,30.78%(n=269) patients had elevated TGA and TMA[16.82%(n=147) had elevated TSH and TGA,TMA simultaneously,13.96%(n=122) had decreased TSH and elevated TGA and TMA simultaneously].In the 874 patients,256(29.29%) were older than 60.Conclusion Elderly people has higher incidence of subclinical thyroid function disorders.We should pay more attention to the detection of this condition,especially in elderly patients.