Long-term follow-up in patients with autonomous thyroid adenoma.
Long-term follow-up in patients with autonomous thyroid adenoma.
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自主性甲状腺腺瘤患者的长期随访。
DOI：
10.1530/acta.0.1280051
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
D. Reinwein
中科院分区：
文献类型：
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作者：
D. Sandrock;T. Olbricht;D. Emrich;G. Benker;D. Reinwein
一组375例未经治疗的甲状腺功能正常的孤立性自主性甲状腺腺瘤患者进行了长期随访研究（观察期52.8（平均值）/46（中位数），范围3-204个月）。在观察期间，133例（34.2%）最初未经治疗的患者因甲状腺功能亢进、机械问题或应患者要求接受治疗（手术、放射性碘、抗甲状腺药物）。67例患者发生甲状腺功能亢进症，平均发病率为每年4.1%。随访期间甲状腺功能亢进症的发病率增加（前7年为3%，随后几年为10%）。年龄、性别、结节大小、最初的甲状腺造影表现和TRH试验在预测甲状腺功能亢进症方面没有个体预后价值。14例未经治疗的甲状腺功能亢进症患者中有11例在随访期间未经治疗甲状腺功能正常。碘过量后（根据病史或尿碘水平升高，N = 45），14例患者（31%）发生甲状腺功能亢进。总之，我们建议至少对高龄、伴发疾病和碘暴露概率较高的患者进行自主性腺瘤的明确治疗。
A group of 375 untreated euthyroid patients with solitary autonomous adenoma of the thyroid were studied in a long-term follow-up (observation period 52.8 (mean)/46 (median), range 3-204 months). During the period of observation, 133 (34.2%) of all initially untreated patients underwent treatment (surgery, radioiodine, antithyroid medication) because of hyperthyroidism, mechanical problems, or at the patient's request. Sixty-seven patients developed hyperthyroidism resulting in a mean incidence of 4.1% per year. The incidence of hyperthyroidism increased during follow-up (3% in the first seven years, 10% in the following years). Age, sex, nodule size, initial scintigraphic appearance and the TRH test were of no individual prognostic value in predicting hyperthyroidism. Eleven of 14 patients with untreated hyperthyroidism became euthyroid without treatment during the time of follow-up. After iodine excess (by history or elevated iodine levels in urine, N = 45), 14 patients (31%) developed hyperthyroidism. In conclusion, we recommend a definitive treatment of autonomous adenoma at least in patients with advanced age, concomitant diseases and a higher probability of iodine exposure.