文档介绍：The physiological functions of thyroid gland
Synthesize, reserve and secrete
thyroxine
n of the thyroid gland
The thyroid scan Thyroid ultrasound Needle biopsy
Other tests specifically related to thyroid function or disease
Anti-thyroid antibodies
thyroid microsomal antibody (TMAb)
thyroglobulin antibodies (TgAb)
thyroid TSH receptor (TRAb’s)
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The roles of thyroid hormones
regulate tissue metabolism central nervous system development
growth and bone maturation
Goiter
Epithelial cells benign hyperplasia, non inflammation and non tumor
Nontoxic goiter (simple goiter): euthyroid甲状腺机能正常的
Classification: endemic sporadic compensatory
Toxic goiter: hyperthyroidism
Diagnosis
thyroid gland intumescence 肿大 (diffuse or/and nodular)，the function of thyroid gland normal , antibodies against oneself are negative
Differential diagnosis
Autoimmune thyroiditis：antibodies are positive如桥本氏炎
Thyroid cancer
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Etiology and pathogenesis
Thyroid gland intumescence
T3 T4 tend to normal
endemic goiter：iodine deficiency
Iodine deficiency
TH insufficience
TSH
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Etiology and pathogenesis
Sporadic goiter
1. diet
iodine
Substances leading thyroid gland intumescence
2. drugs
3. heredity
4. immunity
阻止碘吸收及抑制甲状腺素分泌的物质
如水中的钙和氟、硼、硅 等
卷心菜、甘蓝、芹菜中含有硫氰酸盐或有机氯酸盐，能够妨碍碘向甲状腺集聚。
磺胺类药、硫脲类药，锂、钴等能抑制碘离子的浓集或碘离子有机化。
照影剂，含碘药物等
甲状腺激素合成障碍
检测出一种自身抗体 “甲状腺生长免疫球蛋白”可刺激甲状腺增生肿大。
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Clinical manifestations
Simple thyroid gland intumescence，usually asymptomatic，sever intumescence can cause press symptome I: diameter<3cm II: diameter 3-5 cm
III: diameter 5-7 cm IV: diameter 7-9 cm
V: diameter >9cm
Laboratory findings
T3、T4 、TSH normal
Radioactive iodine uptake increase, but the time of peak dose not move foreward
Thyroid globulin increase
Antibodies to thyroid are negative
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Diagnosis and differential diagnosis
Diagnosis
thyroid gland intumescence (diffuse or/and nodular)，the function of thyroid