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118例临床诊断明确的甲亢患者进行了针吸,110例作出细胞学解释。作者按涂片所见上皮细胞多形性及淋巴细胞浸润程度分四型,Ⅰ、Ⅱ及Ⅲ型与桥本病相似,作者命名为混合型甲亢,Ⅳ为单纯型甲亢。细胞形态学的改变与自身抗体滴度和病程密切相关。自身抗体(TGA、MCA)阳性滴度愈高,病程愈长,这些变化也愈明显。提示甲亢可转变为桥本病。为了避免术后永久性甲减,对甲亢传统手术指征有重新商榷的必要。所有患者应作针吸和MCA、TGA检测。如针吸为混合型,抗体测定为高滴度者不宜手术。
118 cases of clinically diagnosed patients with hyperthyroidism needle aspiration, 110 cases of cytology. According to smear see epithelial cell pleomorphism and lymphocytic infiltration of four types, Ⅰ, Ⅱ and Ⅲ type and Hashimoto’s disease similar to the author named mixed hyperthyroidism, Ⅳ is simple hyperthyroidism. Changes in cell morphology and autoantibody titers and duration are closely related. The higher the titers of autoantibodies (TGA, MCA), the longer the course of disease, the more obvious these changes. Hyperthyroidism can be prompted to Hashimoto’s disease. In order to avoid postoperative permanent hypothyroidism, traditional surgical indications of hyperthyroidism need to be re-discussed. All patients should be aspiration and MCA, TGA detection. Such as mixed needle aspiration, antibody titer is not high for surgery.