超声检查对糖皮质激素治疗亚急性甲状腺炎的临床意义

王春雷++潘燕++韩英++唐浩++卜娟娟

DOI：10.16662/j.cnki.1674-0742.2017.23.191

[摘要] 目的 探討糖皮质激素治疗亚急性甲状腺炎超声检查的临床意义。方法 方便选取在2012年10月—2015年10月期间，该院明确诊断的亚急性甲状腺炎患者118例为研究对象。随机分为临床组和超声组，各59例。两组均给予强的松进行治疗。临床组临床症状全部缓解且维持用药1～2周，以后根据临床症状、体征及血沉下降等的情况进行逐步减量，当临床症状、体征及血沉正常时停药。超声组声像图低回声区明显缩小，病灶周边血流信号仍丰富，探头按压痛消失，即开始逐步减量，当声像图显示低回声区消失，病灶周边血流信号正常予以停药。结果 临床组治愈率86%（51/59），超声组治愈率97%（57/59），两组治愈率差异有统计学意义（P<0.05）。 结论 超声检查能通过对患者甲状腺病变区声像图演变过程的观察，指导糖皮质激素合理治疗亚急性甲状腺炎，有效地提高亚急性甲状腺炎患者治愈率。

[关键词] 亚急性甲状腺炎；糖皮质激素治疗；超声检查

[中图分类号] R581 [文献标识码] A [文章编号] 1674-0742（2017）08（b）-0191-03

Clinical Significance of Ultrasonic Examination in Glucocorticoid Therapy for Subacute Thyroiditis

WANG Chun-lei1， PAN Yan2， HAN Ying1， TANG Hao1， BU Juan-juan1

1.Department of Ultrasound， Liuhe Peoples Hospital， Nanjing， Jiangsu Province， 211599 China； 2.Department of Endocrinology， Liuhe Peoples Hospital， Nanjing， Jiangsu Province， 211599 China

[Abstracts] Objective This paper tries to study the clinical significance of ultrasonic examination in glucocorticoid therapy for subacute thyroiditis. Methods 118 cases of subacute thyroiditis specifically diagnosed in this hospital from October 2012 to October 2015 were convenient studied and randomly divided into the clinical group and the ultrasound group， with 59 cases in each group. Both groups were treated with prednisone. The clinical symptoms in the clinical group were all relieved and the medication was maintained for 1～2 weeks， then the dose was gradually decreased according to the clinical symptoms， physical signs and blood sedimentation， and stop taking medicine when the clinical symptoms， physical signs and blood sedimentation were normal. Dosage of the ultrasound group was reduced when the ultrasound image was significantly reduced in the low echo area， blood flow around the lesion was still abundant， and sore of brain compression was disappeared and drug withdrawal when the ultrasound image was disappeared in the low echo area， blood flow around the lesion was normal. Results The curative rate in the clinical group was 86% （51/59）， and that of the ultrasound group was 97% （57/59）， there was statistically significant difference between the groups （P<0.05）. Conclusion Ultrasound examination can guide the rational glucocorticoid treatment for subacute thyroiditis through the observation of patients with thyroid lesions， and improve the curative rate for patients with subacute thyroiditis.

[Key words] Subacute thyroiditis； Glucocorticoid therapy； Ultrasonic testing

亚急性甲状腺炎是病毒感染、自身免疫、药物、理化因子等破坏甲状腺滤泡所致甲状腺炎症疾病，是最多见的甲状腺疼痛疾病[1]。该文主要阐述由病毒感染引起的甲状腺疾病，又称病毒性甲状腺炎，该病炎症机制尚未阐明。糖皮质激素是公认的治疗亚急性甲状腺炎首选方法，疗效确切，但对药物剂量的调整和停药时点往往来自于患者感觉和医生经验，缺乏标准[2]。该研究方便……