Thyrotoxicosis
Thyrotoxicosis
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DOI：
10.1016/s0140-6736(11)60782-4
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发表时间：
2012-03-24
期刊：
影响因子：
168.9
通讯作者：
Boelaert, Kristien
中科院分区：
文献类型：
--
作者：
Franklyn, Jayne A.;Boelaert, Kristien
甲状腺机能亢进症是一种常见疾病，尤其是在女性中。最常见的原因是格雷夫斯病(自身免疫性甲状腺功能亢进症)。其他重要原因包括由于存在一个或多个自主功能的甲状腺结节而导致的中毒性结节甲亢，以及由炎症引起的甲状腺炎，炎症导致储存的激素释放。抗甲状腺药物通常是最初的治疗药物(硫代胺类药物，如卡比唑或其活性代谢物他巴唑是首选药物)。在大约三分之一的病例中，长期的病程会导致格雷夫斯甲亢的缓解。由于Graves病缓解率低，且仅用抗甲状腺药物无法治愈中毒性结节性甲亢，放射性碘越来越多地被用作一线治疗，是复发性Graves‘甲亢的首选治疗方法。在选定的病例中，全甲状腺切除术是一种选择。未来的努力可能集中在新的和安全的方法来调节潜在的疾病过程，而不是停止过量的甲状腺激素产生。
Thyrotoxicosis is a common disorder, especially in women. The most frequent cause is Graves' disease (autoimmune hyperthyroidism). Other important causes include toxic nodular hyperthyroidism, due to the presence of one or more autonomously functioning thyroid nodules, and thyroiditis caused by inflammation, which results in release of stored hormones. Antithyroid drugs are the usual initial treatment (thionamides such as carbimazole or its active metabolite methimazole are the drugs of choice). A prolonged course leads to remission of Graves' hyperthyroidism in about a third of cases. Because of the low remission rate in Graves' disease and the inability to cure toxic nodular hyperthyroidism with antithyroid drugs alone, radioiodine is increasingly used as first line therapy, and is the preferred choice for relapsed Graves' hyperthyroidism. Total thyroidectomy is an option in selected cases. Future efforts are likely to concentrate on novel and safe ways to modulate the underlying disease process rather than stopping excess thyroid hormone production.