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目的提高对桥本甲状腺炎的认识。方法对 40例桥本甲状腺炎进行长期随访。结果首诊时 16例表现为甲状腺功能亢进症 (甲亢 ) ,14例甲状腺功能正常 ,10例诊断为甲状腺功能减退症 (甲减 ) ;有 2 8例最终演变甲减 ,占 70 % ;所有患者抗甲状腺过氧化物酶抗体 (TPo Ab) ,抗甲状腺球蛋白抗体 (TGAb) ,抗甲状腺微粒体抗体 (Mc Ab)滴度均偏高 ,并有逐步升高趋势。结论桥本甲状腺炎的甲状腺功能可正常 ,也可表现为甲亢或甲减 ,但其本身有自然发生甲减的趋势 ,故最终归为甲减 ;TPo Ab、TGAb、Mc Ab高滴度持续时间较长 ,可达 10年以上 ,其峰值比发病年龄晚 10～ 2 0年 ;肿大的甲状腺或甲状腺结节在随访中可缩小或消失
Objective To raise awareness of Hashimoto’s thyroiditis. Methods 40 cases of Hashimoto’s thyroiditis were followed up for a long time. Results Sixteen cases showed hyperthyroidism (Hyperthyroidism), 14 cases had normal thyroid function, 10 cases were diagnosed as hypothyroidism (hypothyroidism) at the first visit, 28 cases were hypothyroidism (70%), and all patients The titers of anti-thyroid peroxidase (TPo Ab), anti-thyroglobulin antibody (TGAb) and anti-thyroid microsomal antibody (McAb) were both high and gradually increased. Conclusion Hashimoto’s thyroiditis may have normal thyroid function, but also hyperthyroidism or hypothyroidism. However, Hashimoto’s thyroiditis may have hypothyroidism. Therefore, Hypothyroidism is finally classified as hypothyroidism. TPo Ab, TGAb, Mc Ab High titers Duration Longer, up to 10 years or more, the peak than the onset of age 10 to 20 years; enlarged thyroid or thyroid nodules in the follow-up can be reduced or disappeared