[1]孙敏讷,段宇.老年亚临床甲状腺功能减退症的诊治特点[J].国际内分泌代谢杂志,2014,(06):411-414.[doi:10.3760/cma.j.issn.1673-4157.2014.06.014]
　Sun Minne,Duan Yu..Diagnositc and therapeutic characteristics of subclinical hypothyroidism in elderly people[J].International Journal of Endocrinology and Metabolism,2014,(06):411-414.[doi:10.3760/cma.j.issn.1673-4157.2014.06.014]
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老年亚临床甲状腺功能减退症的诊治特点()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2014年06期
页码:
411-414
栏目:
综述
出版日期:
2014-12-20

文章信息/Info

Title:
Diagnositc and therapeutic characteristics of subclinical hypothyroidism in elderly people
作者:
孙敏讷; 段宇
210029 南京医科大学第一附属医院内分泌科
Author(s):
Sun Minne;  Duan Yu.
Department of Endocrinology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
关键词:
亚临床甲状腺功能减退症;  诊断;  治疗;  老年人群
Keywords:
Subclinical hypothyroidism;  Diagnosis;  Treatment;  Elderly population
DOI:
10.3760/cma.j.issn.1673-4157.2014.06.014
摘要:
亚临床甲状腺功能减退症(甲减)是老年人群常见的疾病。诊断标准为血清促甲状腺激素(TSH)水平升高伴游离甲状腺素(FT4)水平正常。TSH正常值上限随年龄增长而升高,但临床上尚缺乏根据年龄调整的TSH正常值范围。老年亚临床甲减与老龄化症状极为相似,易于被忽视。持续性亚临床甲减可对老年人心血管、认知、肌肉骨骼等方面带来负面影响,而TSH小于10 mIU/L的轻度亚临床甲减可能与75岁以上老人长寿相关。老年亚临床甲减的治疗应该强调个体化,TSH大于10 mIU/L或存在其他危险因素时,应给予左旋甲状腺素(L-T4)治疗。初始剂量推荐25～75 μg/d,每4～6周根据TSH水平和临床表现调整剂量,至维持剂量后每6～12个月监测甲状腺功能。
Abstract:
Subclinical hypothyroidism is a common disease among the elderly people. The diagnostic criteria is the abnormally high thyroid stimulating hormone(TSH)level accompanied by normal free T4(FT4)level. It has been proved that the upper limit of normal TSH rises with age, therefore age-adjusted normal range of TSH values are needed which so far are not set up yet. The symptom of subclinical hypothyroidism is extremely similar to that of the aging and easly to be neglected. Persistent subclinical hypothyroidism could affect multiple systems such as cardiovascular system,cognitive function, bone and muscle mass in elder individuals, but mildly elevated TSH(<10 mIU/L)is associated with longevity for whose age were above 75 years old. Individualized treatment should be stressed for aged patients. Thyroxine replacement therapy is generally recommended when TSH is more than 10 mIU/L or there exists other risk factors. The recommended initial dose is 25-75μg/d and should be modified every 4 to 6 weeks according to TSH level and clinical manifestations. Thyroid function should be monitored every 6-12 months after maintenance dose is reached.

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更新日期/Last Update: 2014-12-20