本文選題：亞急性甲狀腺炎　切入點：診斷　出處：《南昌大學》2017年碩士論文　論文類型：學位論文

【摘要】：背景:亞急性甲狀腺炎(Subacute thyroiditis,SAT)由De Quervain于1940年首先描述,又稱De Quervain甲狀腺炎、巨細胞性甲狀腺炎、肉芽腫性甲狀腺炎,是一種可自行恢復的甲狀腺非細菌感染性疾病,臨床發(fā)病率約為4.9/10萬,是甲狀腺疾病中的常見病和多發(fā)病,也是甲狀腺疼痛最常見原因,可能與病毒感染或遺傳易感性有關,常見于20-50歲女性[1]。大多數SAT患者根據其典型的臨床表現(xiàn)、實驗室檢查、131碘攝取率、影像學檢查以及甲狀腺細針穿刺細胞學檢查可明確診斷。由于部分患者癥狀不典型,極易誤診,需與其他甲狀腺疾病相鑒別。臨床上治療急性期SAT常首選糖皮質激素。但SAT的病程長,容易復發(fā),而且激素治療中往往缺少判斷療效的統(tǒng)一標準。故臨床中發(fā)現(xiàn)按常規(guī)方法減量和停藥常常會導致病情反復發(fā)作。目的:通過綜述目前SAT診斷以及治療方法方面的研究,為臨床降低誤診率以及更有效的治療SAT提供一些理論參考。方法:以“亞急性甲狀腺炎、診斷、鑒別診斷、治療”等關鍵詞檢索自1990-2016年收錄于MEDLINE,PubMed,OVID,APS Journals,Engineering Village,ScienceDirectJournal,SpringerLink,Elsevier,中國知網數據庫一CNKI、維普數據庫、萬方數字化期刊群-WanFang、中國生物醫(yī)學文獻數據庫-CBM中的關于SAT診療進展的文獻共122篇,去除重復后余90篇,初篩后余77篇文獻,排除5篇亞急性甲狀腺炎合并格雷夫斯病文獻,排除8篇橋本甲狀腺炎合并亞急性甲狀腺炎文獻,納入分析研究的共64篇文獻進行檢索,找出SAT診斷以及治療的相關研究。結果與結論:目前已有大量關于SAT診斷及治療的文獻,綜合這些研究結果我們可以更加準確掌握其診斷以及鑒別診斷。雖然糖皮質激素是目前臨床上治療急性期SAT的首選藥物,但糖皮質激素的初始劑量、減量依據、停藥時機以及總療程尚無統(tǒng)一標準。所以糖皮質激素治療SAT的安全性、有效性以及減量、停藥的合適時機的確定還需大樣本的前瞻隨機對照研究來證實。
[Abstract]:Background: subacute thyroiditis is first described by de Quervain in 1940. It is also called de Quervain thyroiditis, giant cell thyroiditis, granulomatous thyroiditis. The clinical incidence is about 4.9 / 100,000, which is a common and frequent disease in thyroid disease, and the most common cause of thyroid pain, which may be related to virus infection or genetic susceptibility. Women aged 20-50 years [1] .According to their typical clinical manifestations, most SAT patients can be clearly diagnosed by laboratory examination of iodine uptake rate, imaging examination, and fine needle aspiration cytology of thyroid gland. It is easy to be misdiagnosed and needs to be distinguished from other thyroid diseases. Glucocorticoid is the first choice in clinical treatment of acute SAT. However, the course of SAT is long and easy to recur. In addition, hormone therapy often lacks a unified standard to judge the curative effect. Therefore, it is found in clinical practice that reduction and withdrawal of drugs in accordance with conventional methods often lead to recurrent attacks of the disease. Objective: to review the current research on SAT diagnosis and treatment methods. To reduce the rate of misdiagnosis and to provide some theoretical reference for the more effective treatment of SAT. Methods: to "subacute thyroiditis, diagnosis, differential diagnosis," A total of 122 articles on the progress of SAT diagnosis and treatment were retrieved from 1990 to 2016 in MEDLINE OVID-OVID-APS Journals Engineering VillageScience Direct Journals, CNKI, Weip Database, Wanfang Digital Journal Group, Wan Fang. Chinese Biomedical Literature Database (-CBM), China National knowledge Network Database (CNKI), Weip Database, Wanfang Digital Journal Group, and Chinese Biomedical Literature Database (-CBM). After removing duplication, 90 articles, 77 articles after screening, 5 articles of subacute thyroiditis combined with Graves disease, 8 articles of Hashimoto thyroiditis with subacute thyroiditis were excluded. A total of 64 articles were searched to find out the diagnosis and treatment of SAT. Results and conclusions: there are a large number of literatures on diagnosis and treatment of SAT. Combined with these results, we can have a more accurate diagnosis and differential diagnosis. Although glucocorticoid is the first choice in clinical treatment of acute SAT, the initial dose of glucocorticoid is based on the reduction of glucocorticoid. There is no uniform standard for the timing of withdrawal and the total course of treatment. Therefore, the determination of the safety, efficacy and reduction of glucocorticoid in the treatment of SAT needs to be confirmed by a large sample of prospective randomized controlled studies.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R581.4

【參考文獻】

相關期刊論文 前10條

1 鄧智敏;;亞急性甲狀腺炎應用小劑量糖皮質激素聯(lián)合消炎痛的臨床效果[J];中外醫(yī)學研究;2016年07期

2 凌宏威;劉璇;李偉;應長江;;亞急性甲狀腺炎患者血清鐵蛋白與血沉和C-反應蛋白相關性分析[J];中外醫(yī)學研究;2015年31期

3 邙建波;劉新杰;李敏;;不同劑量潑尼松治療亞急性甲狀腺炎的臨床對照觀察[J];海南醫(yī)學;2015年16期

4 肖文;孫智芳;;探討超聲彈性成像診斷亞急性甲狀腺炎的病程分型中的應用[J];中華臨床醫(yī)師雜志(電子版);2015年13期

5 楊凱;;不同方法制定糖皮質激素應用劑量治療亞急性甲狀腺炎臨床療效分析[J];當代醫(yī)學;2015年18期

6 胡劍卓;許夢君;;中西醫(yī)結合治療亞急性甲狀腺炎臨床觀察[J];實用中醫(yī)藥雜志;2015年04期

7 劉佳;;抗病毒藥物聯(lián)合小劑量強的松治療亞急性甲狀腺炎臨床分析[J];海峽藥學;2015年03期

8 張華;;血清C反應蛋白在亞急性甲狀腺炎診斷中的應用[J];基層醫(yī)學論壇;2015年01期

9 翁燕紅;宋寧燕;楊前勇;熊亞丹;李凱;李奇;;中西醫(yī)結合治療亞急性甲狀腺炎臨床觀察[J];實用中西醫(yī)結合臨床;2014年11期

10 李梓萌;張研;石琳琳;;降鈣素原在亞急性甲狀腺炎鑒別診斷中的應用[J];中華醫(yī)院感染學雜志;2014年11期

，

本文編號：1616850