Two-Years Prospective Follow-Up Study of Subacute Thyroiditis
Two-Years Prospective Follow-Up Study of Subacute Thyroiditis
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亚急性甲状腺炎的两年前瞻性随访研究
DOI：
10.3389/fendo.2020.00047
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发表时间：
2020-02-28
影响因子：
5.2
通讯作者：
Teng, Wei-Ping
中科院分区：
文献类型：
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作者：
Zhao, Na;Wang, Shuo;Teng, Wei-Ping
目的：本前瞻性随访研究的目的是探讨亚急性甲状腺炎（SAT）患者甲状腺功能减退的早期指标和甲状腺体积的最终变化。方法：对61例SAT患者进行2年随访，评估甲状腺功能减退症的发生率和甲状腺体积的变化。数据分析采用二元logistic回归和受试者工作特征曲线。结果如下：在2年的随访期间，我们发现SAT患者在1年和2年时的甲状腺体积显著小于健康对照组，与SAT发作后的初始甲状腺体积相比显著更小（p <0.001）。此外，患有甲状腺功能减退症的SAT患者的甲状腺体积明显小于没有甲状腺功能减退症的SAT患者。早期最大促甲状腺激素（TSH）值（SAT发作后3个月内）与2年时甲状腺功能减退症的发生率密切相关。OR值为1.18（95% CI = 1.01 - 1.38，p = 0.032）。SAT发作后2年发生甲状腺功能减退症与甲状腺功能正常者相比，早期最大TSH值的ROC曲线下面积（AUC）最大值为0.866（p <0.001）。结论：患者的甲状腺体积在SAT发作后显著增加，而在随访期间这些体积减少;在1年和2年的甲状腺体积显著小于正常健康受试者，特别是在SAT合并甲状腺功能减退症的患者。此外，早期最大TSH值可作为SAT发病后2年甲减发展的有效指标。
Purpose: The aim of the present prospective follow-up study was to explore the early indicators of hypothyroidism and the final changes in thyroid volume in subacute thyroiditis (SAT) patients. Methods: We enrolled 61 SAT patients and followed them up for 2 years to assess the incidence of hypothyroidism and changes in thyroid volume. Binary logistic regression and receiver operating characteristic (ROC) curves were used for data analysis. Results: During the 2 years follow-up period, we found that the volumes of the thyroid gland in SAT patients at 1 and 2 years were significantly smaller than those in the healthy control group, which were significantly smaller compared to the initial thyroid volumes after SAT onset (p < 0.001). Also, the thyroid volumes of SAT patients with hypothyroidism were significantly smaller than those of SAT patients without hypothyroidism. The early maximum thyroid-stimulating hormone (TSH) values (within 3 months after SAT onset) were closely related to the incidence of hypothyroidism at 2 years. The OR value was 1.18 (95% CI = 1.01–1.38, p = 0.032). The early maximum TSH value had a maximum area under the ROC curve (AUC) of 0.866 for the development of hypothyroidism 2 years after SAT onset vs. euthyroidism (p < 0.001). Conclusions: The thyroid volumes of patients increased significantly after the onset of SAT, while during the follow-up these volumes decreased; the thyroid volumes at 1 and 2 years were significantly smaller than those of normal healthy subjects, especially in SAT patients with hypothyroidism. Furthermore, the early maximum TSH value could be used as an effective indicator of the development of hypothyroidism 2 years after the onset of SAT.