产后甲状腺炎的临床及超声声像图特点

发布时间：2018-09-19 15:02

【摘要】：目的总结产后甲状腺炎的临床及超声声像图特点,探讨二者之间的关系。方法收集25例产后甲状腺炎患者的症状、体征、实验室检查和超声检查结果并进行统计学分析。结果 (1)、产后甲状腺炎的临床表现复杂多样,既可以表现为甲亢,也可以表现为甲减;(2)、实验室检查:25例患者产后6个月检查,72.0%(18/25)甲状腺过氧化物酶抗体(TPOAb)阳性;产后18个月随访,经过治疗后仍有20.0%(5/25)TSH4.8 m U/L;(3)、超声声像图表现:25例患者均表现为双侧甲状腺增大,A型(回声正常)4例,B型(回声不均匀)6例,C型(回声弥漫性减低)15例。产后18个月随访,10例A型与B型患者1例TSH4.8 m U/L,15例C型患者4例TSH4.8 m U/L;(4)、产后甲状腺炎患者产后6个月不同回声类型相对应的TPOAb和TSH的比较,C型组TPOAb滴度、TSH值均明显高于A型组(P0.05)。结论产后甲状腺炎的临床症状、体征、超声声像图表现无特异性,结合实验室TPOAb测定可确诊;声像图中低回声出现的范围与甲状腺TPOAb滴度水平、甲状腺功能损害程度有关。
[Abstract]:Objective to summarize the clinical and ultrasonographic features of postpartum thyroiditis and to explore the relationship between them. Methods 25 cases of postpartum thyroiditis were collected and analyzed statistically. Results (1) the clinical manifestations of postpartum thyroiditis were complicated and varied, including hyperthyroidism and hypothyroidism. (2) Laboratory examination showed that 72.0% (18 / 25) patients had positive thyroid peroxidase antibody (TPOAb) at 6 months postpartum. After treatment, there were still 20.0% (5 / 25) TSH4.8 U / L; (3) all 25 patients showed bilateral thyroid enlargement type A (normal echo), 4 cases of type B (non-homogeneous echo), 6 cases of type C (diffuse hypoechoic echo) in 15 cases. After 18 months of postpartum follow-up, 10 cases of type A and 1 case of type B were followed up. There were 15 cases of TSH4.8 MU / L and 15 cases of type C with TSH4.8 mu / L; (4) the comparison of TPOAb and TSH corresponding to different echo types of postpartum thyroiditis in patients with postpartum thyroiditis was significantly higher than that in type A group (P0.05). Conclusion the clinical symptoms, signs and sonographic findings of postpartum thyroiditis have no specificity, and can be confirmed by TPOAb in laboratory. The range of hypoechoic appearance in sonogram is related to the level of thyroid TPOAb titer and the degree of thyroid function damage.
【作者单位】：潍坊医学院附属医院影像中心;
【基金】：潍坊市科学技术发展计划项目(201201275)
【分类号】：R445.1;R714.46

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