摘要
慢性淋巴细胞性甲状腺炎于1912年由日本学者首先报道，属于最常见的自身免疫性甲状腺疾病，也是甲状腺功能减退（甲减）最主要的病因，好发于中老年女性。患者起病隐匿，常无特征性的临床表现，容易漏诊。本病诊断尚缺乏国际统一标准，主要依靠一些非特异性的症状与体征，尤其是甲状腺肿大、甲状腺功能减退，并结合相应的辅助检查。如甲状腺自身抗体阳性，且滴度较高，对诊断意义更大。甲状腺穿刺细胞学检查不作为常规项目，但对诊断困难者具有确诊价值。伴有甲减者，需要常规采用替代治疗，尤其是甲状腺肿大明显者、孕妇以及儿童可以给予左旋甲状腺素替代治疗，但仅有亚临床甲减者，或甲状腺功能正常而甲状腺自身抗体阳性的患者是否需要治疗尚存在争议。
Chronic lymphocytic thyroiditis （CLT）, which is reported by Japanese scientist Hashimoto in 1912, is an autoimmune thyroid disease characterized by the destruction of thyroid gland, hypothyroidism and female dominance. The disease is usually insidious onset with no specific clinical manifestations. CLT can be diagnosed based on enlarged thyroid, positive thyroid autoantibodies and hypothyroidism, though no identical diagnostic criteria is currently available. Fine needle aspiration and cytology is useful for the confirmation of CLT, and could be applied in patients with diagnostic difficulty. Thyroid hormone replacement therapy should be introduced in patients with hypothyroidism, especially in pregnant women, children and cases with overt thyroid enlargement, Treatment with thyroxine in patients with subclinical hypothyroidism and euthyroid patients with positive thyroid autoantibodies remains controversial.
出处
《国际内分泌代谢杂志》
2009年第1期57-59,共3页
International Journal of Endocrinology and Metabolism
