INTRODUCTION:Subclinical hyperthyroidism (SCH), also known as mildly symptomatic hyperthyroidism, has recently been diagnosed more frequently. One of the main endogenous causes of this disorder is autonomously functioning thyroid nodule (AFTN). Despite the fact that it is usually asymptomatic, SCH entails repercussions on the cardiovascular system and bone, and it carries a risk of progression to overt hyperthyroidism with a typical clinical picture. Treatment is still controversial, and its benefits are widely debated in literature.
MATERIAL AND METHODS:From 459 patients authors selected a group of 49 patients (10.6% of all subjects with hyperthyroidism), 41 women (83.7%) with AFTN at the stage SCH treated in the Outpatient Endocrinological Clinic and the Department of Endocrinology of the Medical University of Lublin over a three-year period. The method applied in the study was a retrospective analysis of medical records with a particular account of medical history, physical examination, and additional tests obtained during the process of diagnostic and therapeutic procedures.
RESULTS:Forty-one patients (83.7%) suffered from typical symptoms of hyperthyroidism; only eight patients (16.3%) were asymptomatic. The most frequently reported symptoms were tachycardia in women (51.2%) and anxiety in men (50%). The type of thyrostatic drugs and the length of therapy did not affect the outcome of iodine-131 therapy. In the vast majority of the patients (87.8%) radioidodine therapy was effective; 30 patients (61.2%) reached euthyreosis and 13 patients (22.5%) developed hypothyroidism.
CONCLUSIONS:Most patients with SCH in the course of AFTN suffered from typical symptoms of overt hyperthyroidism; only every sixth patient was asymptomatic. The volume of autonomous adenomas did not affect the result of 131I therapy; however, the impact of AFTN volume as well as the thyroid volume on RIT efficacy requires futher investigation. In the vast majority of patients 131I therapy was an effective method of treatment, and an earlier therapeutic effect was observed more often in the patients with focal lesions located in the right lobe.
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【Subclinical hyperthyroidism in the course of autonomous nodules - clinical evaluation.].
【自主性结节过程中的亚临床甲状腺功能亢进-临床评估。】
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DOI：10.5603/EP.a2018.0088文章类型：杂志文章
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简介：亚临床甲状腺功能亢进症（SCH），也称为轻度症状性甲状腺功能亢进症，最近被更频繁地诊断。这种疾病的主要内源性原因之一是自主功能的甲状腺结节（AFTN）。尽管通常无症状，但SCH会对心血管系统和骨骼造成影响，并且具有典型临床表现的发展为明显甲状腺功能亢进的风险。治疗仍然是有争议的，其益处在文献中得到了广泛的争论。
材料与方法：从459例患者中，作者选择了49例患者（占所有甲亢患者的10.6％），41例女性（83.7％）在门诊内分泌科和内分泌科进行SCH期SCH治疗的AFTN患者卢布林大学为期三年。该研究中使用的方法是对病历进行回顾性分析，并特别考虑病史，体格检查以及在诊断和治疗程序过程中获得的其他检查结果。
结果：41例（83.7％）患者出现典型的甲状腺功能亢进症状。仅8例（16.3％）无症状。报告最频繁的症状是女性的心动过速（51.2％）和男性的焦虑（50％）。甲状腺抑制药物的类型和治疗时间不影响碘131治疗的结果。在绝大多数患者（87.8％）中，放射性碘治疗是有效的。 30名患者（61.2％）达到了甲状腺功能正常，13名患者（22.5％）出现甲状腺功能减退。
结论：AFTN过程中大多数SCH患者表现为典型的甲状腺功能亢进症状。只有六分之一的病人没有症状。自主性腺瘤的数量不影响131I治疗的结果。但是，AFTN量和甲状腺量对RIT疗效的影响还需要进一步研究。在绝大多数患者中，131I治疗是一种有效的治疗方法，并且对于位于右叶的局灶性病变的患者，更经常观察到较早的治疗效果。
材料与方法：从459例患者中，作者选择了49例患者（占所有甲亢患者的10.6％），41例女性（83.7％）在门诊内分泌科和内分泌科进行SCH期SCH治疗的AFTN患者卢布林大学为期三年。该研究中使用的方法是对病历进行回顾性分析，并特别考虑病史，体格检查以及在诊断和治疗程序过程中获得的其他检查结果。
结果：41例（83.7％）患者出现典型的甲状腺功能亢进症状。仅8例（16.3％）无症状。报告最频繁的症状是女性的心动过速（51.2％）和男性的焦虑（50％）。甲状腺抑制药物的类型和治疗时间不影响碘131治疗的结果。在绝大多数患者（87.8％）中，放射性碘治疗是有效的。 30名患者（61.2％）达到了甲状腺功能正常，13名患者（22.5％）出现甲状腺功能减退。
结论：AFTN过程中大多数SCH患者表现为典型的甲状腺功能亢进症状。只有六分之一的病人没有症状。自主性腺瘤的数量不影响131I治疗的结果。但是，AFTN量和甲状腺量对RIT疗效的影响还需要进一步研究。在绝大多数患者中，131I治疗是一种有效的治疗方法，并且对于位于右叶的局灶性病变的患者，更经常观察到较早的治疗效果。
