Assessing the effects of thyroid suppression on benign solitary thyroid nodules. A model for using quantitative research synthesis.
Assessing the effects of thyroid suppression on benign solitary thyroid nodules. A model for using quantitative research synthesis.
复制标题
评估甲状腺抑制对良性孤立性甲状腺结节的影响。
DOI：
10.1097/00005792-200001000-00002
复制
发表时间：
2000
期刊：
影响因子：
1.6
通讯作者：
Pucino,F
中科院分区：
文献类型：
--
作者：
Csako,G;Byrd,D;Wesley,RA;Sarlis,NJ;Skarulis,MC;Nieman,LK;Pucino,F
触诊发现的甲状腺结节占一般成年人的4%-7%(78例)，尸检发现的甲状腺结节占30%-60%(54例，87例)，高分辨率超声检查发现13%-67%的甲状腺结节(“甲状腺偶发瘤”)(7例，54例，84例，87例)。临床上明显的甲状腺结节发生率女性(-5%)高于男性(1%)，并在45岁(7岁、78岁、87岁)以后增加。细针吸取约75%的结节是良性的(19，54)。甲状腺激素在20世纪50年代初(40，66)首次用于治疗孤立性甲状腺结节，随后进行了大量研究(3，4，9，12，15-17，23，31-33，36，38，46，47，49，50，52，59，60，65，68，72，78，79，82，85，89)。然而，这些研究的结论是相互矛盾的。研究设计经常因样本量不足以及缺乏随机化、适当的对照和掩蔽而存在缺陷。一些研究未能确定最初的结节大小，一些研究可能包括囊肿、桥本甲状腺炎、多结节甲状腺疾病、腺瘤和癌症。关于甲状腺激素的类型(去甲肾上腺素、利托洛宁[LT]和左旋甲状腺素[LT])和给药剂量，研究之间也存在不一致。
Thyroid nodules are found in 4%–7% of the general adult population by palpation (78), 30%–60% by autopsy studies (54, 87), and 13%–67% by high-resolution ultrasonography (“thyroid incidentalomas")(7, 54, 84, 87). The incidence of clinically apparent thyroid nodules is higher in women (-5%) than in men (< 1%), and increases after the age of 45 years (7, 78, 87). Approximately 75% of nodules are benign by fine-needle aspiration (19, 54). Thyroid hormone was first used for the management of solitary thyroid nod-ules in the early 1950s (40, 66) and numerous studies have been conducted subsequently (3, 4, 9, 12, 15–17, 23, 31–33, 36, 38, 46, 47, 49, 50, 52, 59, 60, 65, 68, 72, 78, 79, 82, 85, 89). The conclusions of these studies are conflicting, however. Study designs were often flawed by inadequate sample size and by lack of randomization, appropriate controls, and masking. Sev-eral studies failed to define the initial nodule size, and some studies likely included cases of cysts, Hashimoto thyroiditis, multinodular thyroid disease, adenomas, and cancer. Inconsistencies also occurred among studies with regard to the type (desic-cated thyroid, liothyronine [LT), and levothyroxine [LT) and dose of thyroid hormone administration,