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首页 > 医学词汇大全 > Hypothyroidism
Hypothyroidism

内分泌

关键词内分泌 疾病 内分泌系统疾病

词汇介绍

拓展阅读

解析

hypothyroidism   英 /,haɪpəʊ'θaɪrɒɪdɪz(ə)m]/   美 /'haɪpo'θaɪrɔɪ'dɪzəm/

释    义   n. 甲状腺功能减退;甲状腺官能不足病

例    句   The risk factors responsible for hypothyroidism were not evident from the statistical analysis of these cases. 甲状腺功能减退的相应风险因素在这些病例的统计学分析中并不明显。

概述

甲状腺功能减退症,也称为甲状腺功能低下,是一种内分泌系统疾病,主要因为甲状腺不能产生足够的甲状腺激素而发病。这可能会导致一些症状,如不能忍受寒冷,易疲倦,便秘,抑郁症,和体重增加。由于甲状腺肿,有时可能会出现颈部前部肿胀。怀孕期间未经治疗的甲状腺功能减退症可导致婴儿发生先天性碘缺乏综合症和智力发育延迟。临床诊断血液中甲状腺刺激素水平的实验室检测被认为是甲状腺功能减退症的最佳初始检测方法,TSH水平通常在几周后获得确认。在其他疾病的情况下,TSH水平可能是异常的,并且除非强烈怀疑甲状腺功能障碍

Lesson from inappropriate TSH-receptor antibody measurement in hypothyroidism: case series and literature review复制标题

甲状腺功能减退症TSH受体抗体检测不当的教训: 病例系列和文献综述

发表时间:2019-08-27

影响因子:3.6

作者: Arnaud Jannin

期刊:Clin Chem Lab Med

Autoimmune thyroid diseases (AITD) occur frequently, and two biological markers of thyroid autoimmunity are used routinely: anti-thyroid peroxidase antibodies (TPOAbs) and anti-thyrotropin receptor (TSHR) antibodies (TRAbs). According to the American guidelines, TPO-Abs should not be measured in every patient with hypothyroidism but in those with subclinical hypothyroidism, as in these cases results can modify patient management. Otherwise, measurement of TRAbs is recommended in all cases of hyperthyroidism for the diagnosis of Grave’s disease (GD). In contrast to TPO-Abs, TRAbs are directly responsible for thyroid dysfunction. Stimulating TRAbs, known as thyroid stimulating antibodies (TSAbs), activate the cAMP pathway through TSHR, leading to hyperthyroidism. In some patients, other TRAbs, known as thyroid blocking antibodies (TBAbs) act rather as competitive inhibitors of TSH binding to TSHR, thereby favoring hypothyroidism. The functional activity of TRAbs can be evaluated by a bioassay. The presence of TBAbs has been mainly described in GD, where a “switch” in the production of TSAbs towards TBAbs has been described. The prevalence of TBAbs in patients with AITD has been estimated at 9.3%. Despite a large amount of literature on these antibodies, data about the clinical presentation of hypothyroidic patients with TBAbs are scarce. Indeed, testing for TBAbs is recommended in pregnant women with a history of GD; it is also often done in patients with GD with difficulty in treatment adjustment or secondary progression towards hypothyroidism, as well as in patients with orbitopathy without GD. Between 2010 and 2017, a functional TRAbs bioassay was requested by the Department of Biology at Lille University for 39 patients, including 30 patients with such a background and nine patients having hypothyroidism without a history of hyperthyroidism or ophthalmopathy. We therefore reviewed the clinical presentation of these nine patients (Table 1).

译文

自身免疫性甲状腺疾病(AITD)经常发生,常规使用甲状腺自身免疫的两种生物标志物:抗甲状腺过氧化物酶抗体(TPOAbs)和抗促甲状腺激素受体(TSHR)抗体(TRAbs)。根据美国指南,TPO-Abs不应该在每位甲状腺功能减退症患者中进行测量,而应该在亚临床甲状腺功能减退症患者中进行测量,因为在这些情况下,结果可以改变患者管理。否则,建议在甲状腺功能亢进症的所有病例中测量TRAb,以诊断Grave病(GD)。与TPO-Abs相比,TRAb直接导致甲状腺功能障碍。刺激TRAb,称为甲状腺刺激抗体(TSAbs),通过TSHR激活cAMP途径,导致甲状腺机能亢进。在一些患者中,其他TRAb(称为甲状腺阻滞抗体(TBAbs))作为TSH与TSHR结合的竞争性抑制剂起作用,从而有利于甲状腺机能减退。 TRAb的功能活性可以通过生物测定来评估。 TBAb的存在主要在GD中描述,其中已经描述了TSAb生成TBAb的“转换”。 AITD患者中TBAbs的患病率估计为9.3%。尽管有大量关于这些抗体的文献,但关于甲状腺功能减退症患者TBAb临床表现的数据很少。事实上,对于有GD病史的孕妇,建议进行TBAbs检测;它也经常在GD患者中进行,治疗调整困难或甲状腺功能减退继发进展,以及没有GD的眼眶病变患者。在2010年至2017年期间,里尔大学生物系要求对39名患者进行功能性TRAbs生物测定,其中包括30名具有此类背景的患者和9名甲状腺功能减退症患者,无甲状腺功能亢进症或眼病史。因此,我们回顾了这9名患者的临床表现(表1)。