文档介绍：Thyrotoxicosis
Introduction
Thyrotoxicosis is the constellation of clinical findings that arise when the peripheral tissues are presented with and respond to an excess of thyroid hormone—free thyroxine (T4) and free triiodothyronine (T3). Hyperthyroidism refers to sustained increases in thyroid hormone synthesis and secretion by the thyroid gland. The prevalence of hyperthyroidism is estimated at 2% for women and % for men. About 15% of cases occur in patients older than 60 years.
甲状腺毒症
简介
甲状腺毒症是一组临床症候群,出现在甲状腺激素,即游离甲状腺素(T4)和游离甲状腺素(T3)过量时,外围组织的临床表现。甲状腺功能亢进症是指甲状腺合成和分泌甲状腺激素持续增加。甲状腺功能亢进症的患病率估计女性为2%,%。约15%的病例发生在60岁以上患者。
The mon causes of thyrotoxicosis in Western society are Graves’ disease, autonomous single nodules (also known as toxic hot nodules), multiple functioning nodules (also called toxic multinodular goiter), and thyroiditis. The pathogenesis in each of these conditions is different (Table 42-1). However, the initial therapy is similar and focuses on blocking the peripheral effects of thyroid hormone excess and reducing thyroid hormone overproduction where present.
在西方社会,甲状腺毒症最常见的病因是Graves'病,单发结节(又称毒热结节),多发功能性结节(也称为毒性多结节性甲状腺肿)和甲状腺炎。上述疾病的发病机制不同(表42-1)。但目前主要的治疗方法是类似的,主要是阻断过量甲状腺激素对周围组织的作用,并减少甲状腺激素的生成。
Etiology and Pathogenesis
Graves’ disease is the mon cause of hyperthyroidism in patients younger than 40 years (Fig. 42-1). The pathophysiology represents one of the classic receptor antibody disease states due to thyroid-stimulating hormone (TSH) receptor autoantibodies that continuously stimulate the thyroid gland as TSH agonists. Intrathyroidal lymphocytic infiltrate is the initial abnormality (Fig. 42-2). As in other autoimmune disease states, females are monly affected than males. Autonomously functioning thyroid nodules are discrete and function independently of the pituitary-thyroid negative feedback loop. Thyroiditis is characterized by inflammation, with thyroidal damage leading to release of T4 and T3 without active formation of T4 and T