亚急性甲状腺炎及其临床特征-回顾性单中心临床研究

N. Manevska, N. Bozinovska, B. Stoilovska Rizova, S. Stojanoski, T. Makazlieva
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摘要

介绍。亚急性甲状腺炎(SAT)的典型临床特征通常被评估为颈部疼痛和高体温,以及甲状腺功能异常,炎症标志物升高,强烈提示低回声超声特征。使用非类固醇抗炎药和皮质类固醇。通过测定甲状腺激素水平、甲状腺的大小和结构以及超声和显像检查,探讨SAT患者的临床特征。材料和方法。我们对2015-2020年期间122例SAT患者(男女,平均年龄45.05±12.18岁)进行了回顾性分析。我们评估了每月SAT发生的频率、患者的临床状况,包括症状、体温、FT4和TSH的实验室结果、CRP和ESR水平、超声和闪烁成像结果。大多数患者主诉颈部疼痛,66/100(66%)患者检测到高体温。CRP和ESR通常诊断为甲状腺功能亢进期。超声多见甲状腺肿大,52例甲状腺正常,以低回声非同质结构为主。显像显示72/98(73,47%)患者有“空”扫(未见功能性甲状腺组织),26/98(26,53%)患者主要双叶缺位。需要提高医生对颈痛患者的认识,以正确诊断SAT,这往往是经常误诊或延误,导致错误的抗生素过度使用。一般来说,非甾体类抗炎药对减轻轻度患者甲状腺疼痛有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Subacute thyroiditis and its clinical characteristics — a retrospective single center clinical study
INTRODUCTION. Typical clinical features of subacute thyroiditis (SAT) are commonly assessed such as – neck pain and high body temperature, as well as thyroid function abnormalities, elevated inflammatory markers, and strongly suggestive hypoechoic ultrasonography characteristics. Non-steroid anti-inflammatory agents and corticosteroids are used.AIM. To examine the clinical characteristics in patients with SAT, by determining the level of thyroid hormones, the size and structure of the thyroid gland as well as ultrasound and scintigraphy findings.MATERIALS AND METHODS. We performed retrospective analysis in 122 cases of SAT (both genders, mean age 45.05±12,18 years), in the period 2015-2020. We evaluated monthly frequency of the SAT occurrence, the clinical status of the patients including symptoms, body temperature, laboratory results of FT4 and TSH, CRP and ESR level, ultrasonography and scintigraphy findings.RESULTS. Most of the patients complained of neck pain, high body temperature was detected in 66/100 (66%) pts. CRP and ESR Patients were usually diagnosed in hyperthyroid phase of the disease. Enlarged thyroid gland was mostly seen on US, while 52 had normal thyroid gland, with predominantly hypoechoic non-chomogenous structure. Scintigraphy noted “empty” scan (without presentation of functional thyroid tissue) in 72/98 (73,47%) and hypofixation mainly in both lobes in 26/98 (26,53%) pts.CONCLUSION. The awareness of physicians needs to be increased in patients with neck pain for proper diagnosis of SAT, that is often is often misdiagnosed or delayed, leading to erroneous antibiotic overuse. Generally, nonsteroidal anti-inflammatory drugs are effective in reducing thyroid pain in patients with mild cases.
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