亚临床甲状腺功能亢进症的诊治

摘要

亚临床甲状腺功能亢进症(subclinical hyperthyroidism,SH)是一种特殊类型的甲状腺功能亢进症(甲亢),是指血清促甲状腺激素(thyroid stimulating hormone,TSH)水平低于正常参考值下限,而总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、游离 T3、游离 T4在正常值范围,伴或不伴有轻微的甲亢症状。随着 TSH 测定方法的改进, SH 的检出率明显升高。大多数 SH 患者可不经治疗自行缓解,但仍有部分患者进展为临床甲亢,并出现严重的并发症,如对心血管系统的负面影响,加重骨质疏松和促进骨折发生、老年性痴呆等。因此正确处理 SH 具有重要的临床意义。%ABSTRACT:Subclinical hyperthyroidism (SH)is diagnosed in patients having a persistently low or undetectable serum concentration of thyroid-stimulating hormone (TSH)with normal total triiodothyronine,total thyroxine,free triiodothyronine and free thyroxine concentrations,with or without minor symptoms of hyperthyroidism.With the development of the determination method of TSH,the detection rate of SH was increased significantly.Most of the patients with SH can be spontaneous remission without treatment,but there are still some patients to have progress for clinical hyperthyroidism. SH is associated with some serious complications, such as the negative effects on cardiovascular system,osteoporosis,fratures,senile dementia,and so on.It has an important clinical significance to treat SH precisely.