CLINICAL PRACTICE GUIDELINES FOR HYPOTHYROIDISM IN ADULTS: COSPONSORED BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND THE AMERICAN THYROID ASSOCIATION
CLINICAL PRACTICE GUIDELINES FOR HYPOTHYROIDISM IN ADULTS: COSPONSORED BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND THE AMERICAN THYROID ASSOCIATION
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DOI：
10.4158/ep12280.gl
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发表时间：
2012-11-01
影响因子：
4.2
通讯作者：
Woeber, Kenneth A.
中科院分区：
文献类型：
--
作者：
Garber, Jeffrey R.;Cobin, Rhoda H.;Woeber, Kenneth A.
目的：甲状腺功能减退症的病因和临床表现多种多样。适当的治疗需要准确的诊断，并受共存的医疗条件的影响。本文介绍了以证据为基础的临床指南甲状腺功能减退症门诊patients.Methods的临床管理：这些指南的发展是委托美国临床内分泌学家协会（AACE）与美国甲状腺协会（ATA）。AACE和ATA组建了一个由撰写本文的专家临床医生组成的工作组。作者审查了相关文献，并采取了循证医学方法，结合他们的知识和经验，制定了一系列具体的建议和这些建议的理由。强度的建议和质量的证据支持每一个被评为根据美国临床内分泌学家协会协议标准化生产的临床Guidelines-2010 update.Results的方法：主题包括病因，流行病学，临床和实验室评价，管理，甲状腺功能减退症的后果。筛查，治疗亚临床甲状腺功能减退症，怀孕，和未来的研究领域也covered.Conclusions：五十二个循证建议和subrecommendations开发，以帮助甲状腺功能减退症患者的护理，并分享作者认为是目前，合理的，最佳的医疗实践甲状腺功能减退症的诊断和护理。血清促甲状腺激素是绝大多数门诊患者原发性甲状腺功能障碍的最佳筛查方法。标准治疗是用L-甲状腺素替代。当血清促甲状腺激素低于10 mIU/L时，应根据患者的具体情况决定是否治疗亚临床甲状腺功能减退症。
Objective: Hypothyroidism has multiple etiologies and manifestations. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions. This paper describes evidence-based clinical guidelines for the clinical management of hypothyroidism in ambulatory patients.Methods: The development of these guidelines was commissioned by the American Association of Clinical Endocrinologists (AACE) in association with American Thyroid Association (ATA). AACE and the ATA assembled a task force of expert clinicians who authored this article. The authors examined relevant literature and took an evidence-based medicine approach that incorporated their knowledge and experience to develop a series of specific recommendations and the rationale for these recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach outlined in the American Association of Clinical Endocrinologists Protocol for Standardized Production of Clinical Guidelines-2010 update.Results: Topics addressed include the etiology, epidemiology, clinical and laboratory evaluation, management, and consequences of hypothyroidism. Screening, treatment of subclinical hypothyroidism, pregnancy, and areas for future research are also covered.Conclusions: Fifty-two evidence-based recommendations and subrecommendations were developed to aid in the care of patients with hypothyroidism and to share what the authors believe is current, rational, and optimal medical practice for the diagnosis and care of hypothyroidism. A serum thyrotropin is the single best screening test for primary thyroid dysfunction for the vast majority of outpatient clinical situations. The standard treatment is replacement with L-thyroxine. The decision to treat subclinical hypothyroidism when the serum thyrotropin is less than 10 mIU/L should be tailored to the individual patient.