摘要
目的:对新型冠状病毒疫苗接种后发生的亚急性甲状腺炎(SAT)患者案例特点回顾分析。方法:检索2020年1月至2022年6月PubMed和中国知网(CNKI)发表COVID-19疫苗接种后明确诊断SAT的完整资料报道,统计其作者、国家、性别、接种COVID-19疫苗类型、亚甲炎临床症状、核酸/抗体检测、甲状腺功能和相应的炎症指标、甲状腺超声显像、甲状腺摄碘率或者核素扫描情况以及治疗用药和甲状腺功能复查情况。结果:个案报道有共同特点,出现发热、颈部疼痛、促甲状腺素(TSH)水平偏低、FT4和FT3水平偏高、甲状腺球蛋白抗体(TGAb)和过氧化物酶抗体(TPOAb)均阴性;炎症指标血沉(ESR)和C‑反应蛋白(CRP)明显偏高;甲状腺的声学改变,非甾体类抗炎药和普萘洛尔对症治疗4~8周后甲状腺功能恢复正常,症状消退。结论:COVID‑19疫苗接种后可能会出现SAT的发生,通过分子模拟途径和遗传易感性得以实现,佐剂途径影响还需商榷,其结果预后良好,提醒临床医生重视。
Objective:To review the case reports on subacute thyroiditis(SAT)after vaccination of SARS‑CoV‑2.Methods:The literature were searched in PubMed and CNKI databases from January 2020 to June 2022 on the cases of SAT after SARS‑CoV‑2 vaccination.The author,country,gender,types of COVID‑19 vaccine,clinical symptoms of subthyroiditis,nucleic acid/antibody detection,thyroid function,and inflammatory indicators,thyroid ultrasound imaging,thyroid iodine uptake rate or nuclide scanning,treatment,and follow‑up were analyzed.Results:Most cases had common characteristics,such as fever,neck pain,low levels of thyrotropin(TSH),high levels of FT4 and FT3,and negative thyroglobulin antibody(TGAb)and peroxidase antibody(TPOAb).Inflammatory indicators,ESR and C‑reactive protein(CRP),were significantly higher.Acoustic changes were found in thyroid.But after 4 to 8 weeks'treatment by NSAIDs and propranolol,most synptoms and thyroid function returned to normal.Conclusion:SAT might occur after vaccination of SARS‑CoV‑2,which could be achieved through molecular simulation pathway and genetic susceptibility.The influence of adjuvant pathway during vaccination should be concerned,although the outcomes of the patients are good.
作者
邢渊
曹瑞菊
魏美君
XING Yuan;CAO Ruiju;WEI Meijun(Qinzhou District People's Hospital of Tianshui,Tianshui 741000,Gansu,China;The First People's Hospital of Tianshui,Tianshui 741000,Gansu,China)
出处
《武汉大学学报（医学版）》
CAS
2023年第12期1441-1446,共6页
Medical Journal of Wuhan University
