Frequency of thyroid disease among Southeast Asian primary care patients.
Frequency of thyroid disease among Southeast Asian primary care patients.
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东南亚初级保健患者的甲状腺疾病频率。
DOI：
10.1046/j.1365-2710.1996.89375893.x
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发表时间：
1996
影响因子：
2
通讯作者：
Buchwald,D
中科院分区：
文献类型：
--
作者：
Weigle,DS;Hooton,TM;Toivola,B;Kith,P;Buchwald,D
我们前瞻性地评估了 99 名前往专门为难民提供护理的初级保健诊所就诊的东南亚人是否患有甲状腺疾病。受试者作为新患者正在接受评估，并且之前没有诊断出甲状腺异常。每位患者均由其初级保健提供者进行体检，获得一份侧重于甲状腺疾病症状的标准化调查问卷，并接受静脉穿刺以测定总甲状腺素、三碘甲状腺原氨酸树脂摄取和促甲状腺素 (TSH) 浓度。那些检查、计算出的游离甲状腺素指数（FT4I）或TSH水平异常的患者由内分泌科医生重新检查，并进行重复的甲状腺研究。尽管 81% 的患者报告有 ≥ 1 种与甲状腺功能障碍相符的症状，但只有 17% 的患者发现实验室异常。分别有 5% 和 13% 的受试者出现 FT4I 和 TSH 水平异常，但仅确认 1 例有临床意义的甲状腺功能亢进症，没有确诊甲状腺功能减退症病例。 12% 的受试者注意到 TSH 抑制，中位随访时间为 6 个月。在 7 名甲状腺解剖异常的患者中，4 名 FT4I 或 TSH 异常。我们的结论是，东南亚人群中症状性甲状腺功能障碍的临床患病率与非亚洲人群的临床患病率相当，但亚临床甲状腺功能亢进症的发生率可能更高。尽管提示甲状腺疾病的症状很常见，但本研究并未指出对甲状腺疾病进行常规筛查。
We prospectively assessed 99 Southeast Asians for the presence of thyroid disease who were attending a primary care clinic devoted to the care of refugees. Subjects were undergoing evaluation as new patients and had no previously diagnosed thyroid abnormality. Each patient had a physical examination performed by his or her primary‐care provider, was given a standardized questionnaire that focused on symptoms of thyroid disease and underwent a venipuncture for total thyroxine, triiodothyronine resin uptake and thyrotropin (TSH) concentration. Those who had an abnormal examination, calculated free thyroxine index (FT4I) or TSH level were re‐examined by an endocrinologist and had repeat thyroid studies performed. Although 81% of patients reported ≥1 symptom compatible with thyroid dysfunction, only 17% were found to have laboratory abnormalities. An abnormal FT4I and TSH level was found in 5% and 13% of subjects, respectively, but only one case of clinically significant hyperthyroidism and no cases of hypothyroidism were confirmed. TSH suppression, noted in 12% of subjects, persisted over a median follow‐up of 6 months. Among seven patients with an anatomic abnormality of the thyroid, four had an abnormal FT4I or TSH. We conclude that the clinical prevalence of symptomatic thyroid dysfunction among Southeast Asians is comparable to that reported for non‐Asian populations, but that the frequency of subclinical hyperthyroidism may be higher. Although symptoms suggestive of thyroid disease are common, routine screening for thyroid disease is not indicated in this study.