本文由小咖机器人翻译整理

期刊来源：Lancet

原文链接：https://doi.org/10.1016/S0140-6736(23)02016-0

摘要内容如下：

甲状腺毒症引起多种症状和不良健康后果。甲状腺功能亢进是指甲状腺激素合成和分泌增加，最常见的原因是格雷夫斯病或毒性结节性甲状腺肿，而甲状腺炎（典型的自身免疫性、病毒或药物诱导）引起的甲状腺毒症不伴有甲状腺功能亢进。诊断依据是血清促甲状腺激素（TSH）浓度受到抑制，同时伴有游离甲状腺素和总三碘甲状腺原氨酸或游离三碘甲状腺原氨酸浓度升高（显性甲状腺功能亢进）或在一定范围内（亚临床甲状腺功能亢进）。通过临床评估、TSH受体抗体检测和放射性核素甲状腺闪烁扫描（如有必要）来确定根本原因。甲状腺功能亢进的治疗选择包括抗甲状腺药物、放射性碘和甲状腺切除术，而甲状腺炎则通过对症治疗或糖皮质激素治疗。在Graves病中，一线治疗是12-18个月的抗甲状腺药物疗程，而对于甲状腺肿，放射性碘或手术是毒性结节或甲状腺肿的首选。证据也支持抗甲状腺药物长期治疗作为Graves病和毒性结节性甲状腺肿患者的一种选择。

英文原文如下：

Abstracts

Thyrotoxicosis causes a variety of symptoms and adverse health outcomes. Hyperthyroidism refers to increased thyroid hormone synthesis and secretion, most commonly from Graves' disease or toxic nodular goitre, whereas thyroiditis (typically autoimmune, viral, or drug induced) causes thyrotoxicosis without hyperthyroidism. The diagnosis is based on suppressed serum concentrations of thyroid-stimulating hormone (TSH), accompanied by free thyroxine and total or free tri-iodothyronine concentrations, which are raised (overt hyperthyroidism) or within range (subclinical hyperthyroidism). The underlying cause is determined by clinical assessment, detection of TSH-receptor antibodies and, if necessary, radionuclide thyroid scintigraphy. Treatment options for hyperthyroidism include antithyroid drugs, radioactive iodine, and thyroidectomy, whereas thyroiditis is managed symptomatically or with glucocorticoid therapy. In Graves' disease, first-line treatment is a 12-18-month course of antithyroid drugs, whereas for goitre, radioactive iodine or surgery are preferred for toxic nodules or goitres. Evidence also supports long-term treatment with antithyroid drugs as an option for patients with Graves' disease and toxic nodular goitre.

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