解读桥本病(桥本氏甲状腺炎)

2019-12-06 北京广济医院甲状腺 健康号

桥本氏甲状腺炎(Hashimoto’s thyroiditis,HT)亦称桥本病,是自身免疫性甲状腺炎,又称慢性淋巴性甲状腺炎。

桥本氏甲状腺炎(Hashimoto’s thyroiditis,HT)亦称桥本病,是自身免疫性甲状腺炎,又称慢性淋巴性甲状腺炎。

甲状腺过氧化物酶(TPO)是甲状腺微粒体的主要抗原成分, 抗甲状腺过氧化物酶抗体(TPOAb)直接对抗甲状腺过氧化物酶,TPOAb与自身免疫性甲状腺疾病(AITD)的发生、发展密切相关,一般出现TPOAb偏高,就代表人体遭受自身免疫性甲状腺疾病的侵害。

甲状腺球蛋白( TG)主要是以胶体形式贮存于甲状腺滤泡腔中,在致病因素作用下,甲状腺球蛋白从甲状腺滤泡内溢入血液,则可作为抗原产生抗甲状腺球蛋白抗体(TGAb),此抗体是甲状腺疾病中首先发现的自身抗体 ,具有高度特异性。正常健康人群TGAb一般是阴性,TGAb阳性以慢性淋巴性甲状腺炎(桥本氏甲状腺炎)最高。

它们是最常检测的甲状腺抗体。TGAb、TPOAb 抗体升高往往提示自身免疫性甲状腺疾病或桥本甲状腺炎。

二维超声:诊断基础

体积:可以正常、增大或缩小(峡部增大不是特征)。

实质:早期正常或不均匀,或呈片状减低,无占位效应;进展期减低回声的范围扩大、融合,残余组织多呈高回声、结节样;后期正常组织消失,呈低回声,其内可见线状强回声的纤维化结构,呈网格状分布。

淋巴结:双侧颈部Ⅵ区淋巴结增大较为常见,是淋巴结反应性增生所致。

彩色多普勒超声(CDFI):鉴别诊断

1.血流正常或增多,甲状腺上动脉内径较正常者增粗但小于甲亢患者,流速增高但低于甲亢患者(正常甲状腺上动脉内径<2.0mm,Vmax< 30cm/s)。

2.假“火海征”(HT代偿过度的表现)。

典型的,弥漫性桥本,结合甲功及抗体水平,几乎就可以确诊。

但如果是局灶性病变,则常常是不能的,或者说偏差可能相对较大的,这个还是拿报告给临床医生判断和进一步确诊。

真的是桥本病,也不要过分担心,早期的桥本病完全可以通过中医治疗恢复,积极治疗就可以了。至于癌变,患不患桥本病癌变率都是一样的。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=920498, encodeId=6f9892049800, content=中医治疗何种为规范?, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Thu Jan 28 07:04:16 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900018, encodeId=361490001863, content=中医治疗桥本方法可以来一篇了,有很好的指导意义!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=0cc51876313, createdName=ms4408957580485341, createdTime=Tue Nov 17 22:40:47 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677281, encodeId=919c16e728109, content=<a href='/topic/show?id=56b36239208' target=_blank style='color:#2F92EE;'>#桥本病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62392, encryptionId=56b36239208, topicName=桥本病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad7e27471083, createdName=zhishijing, createdTime=Thu Jan 16 15:18:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580309, encodeId=244d158030938, content=<a href='/topic/show?id=eb416989070' target=_blank style='color:#2F92EE;'>#甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69890, encryptionId=eb416989070, topicName=甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=466b16623777, createdName=ms7517674339485982, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1613757, encodeId=e1c91613e5711, content=<a href='/topic/show?id=00fa623901d' target=_blank style='color:#2F92EE;'>#桥本氏甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62390, encryptionId=00fa623901d, topicName=桥本氏甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=250e19422941, createdName=ms3875500703114551, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=)]
    2021-01-28 carrotlyl

    中医治疗何种为规范?

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=920498, encodeId=6f9892049800, content=中医治疗何种为规范?, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Thu Jan 28 07:04:16 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900018, encodeId=361490001863, content=中医治疗桥本方法可以来一篇了,有很好的指导意义!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=0cc51876313, createdName=ms4408957580485341, createdTime=Tue Nov 17 22:40:47 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677281, encodeId=919c16e728109, content=<a href='/topic/show?id=56b36239208' target=_blank style='color:#2F92EE;'>#桥本病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62392, encryptionId=56b36239208, topicName=桥本病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad7e27471083, createdName=zhishijing, createdTime=Thu Jan 16 15:18:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580309, encodeId=244d158030938, content=<a href='/topic/show?id=eb416989070' target=_blank style='color:#2F92EE;'>#甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69890, encryptionId=eb416989070, topicName=甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=466b16623777, createdName=ms7517674339485982, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1613757, encodeId=e1c91613e5711, content=<a href='/topic/show?id=00fa623901d' target=_blank style='color:#2F92EE;'>#桥本氏甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62390, encryptionId=00fa623901d, topicName=桥本氏甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=250e19422941, createdName=ms3875500703114551, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=)]
    2020-11-17 ms4408957580485341

    中医治疗桥本方法可以来一篇了,有很好的指导意义!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=920498, encodeId=6f9892049800, content=中医治疗何种为规范?, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Thu Jan 28 07:04:16 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900018, encodeId=361490001863, content=中医治疗桥本方法可以来一篇了,有很好的指导意义!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=0cc51876313, createdName=ms4408957580485341, createdTime=Tue Nov 17 22:40:47 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677281, encodeId=919c16e728109, content=<a href='/topic/show?id=56b36239208' target=_blank style='color:#2F92EE;'>#桥本病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62392, encryptionId=56b36239208, topicName=桥本病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad7e27471083, createdName=zhishijing, createdTime=Thu Jan 16 15:18:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580309, encodeId=244d158030938, content=<a href='/topic/show?id=eb416989070' target=_blank style='color:#2F92EE;'>#甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69890, encryptionId=eb416989070, topicName=甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=466b16623777, createdName=ms7517674339485982, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1613757, encodeId=e1c91613e5711, content=<a href='/topic/show?id=00fa623901d' target=_blank style='color:#2F92EE;'>#桥本氏甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62390, encryptionId=00fa623901d, topicName=桥本氏甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=250e19422941, createdName=ms3875500703114551, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=920498, encodeId=6f9892049800, content=中医治疗何种为规范?, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Thu Jan 28 07:04:16 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900018, encodeId=361490001863, content=中医治疗桥本方法可以来一篇了,有很好的指导意义!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=0cc51876313, createdName=ms4408957580485341, createdTime=Tue Nov 17 22:40:47 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677281, encodeId=919c16e728109, content=<a href='/topic/show?id=56b36239208' target=_blank style='color:#2F92EE;'>#桥本病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62392, encryptionId=56b36239208, topicName=桥本病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad7e27471083, createdName=zhishijing, createdTime=Thu Jan 16 15:18:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580309, encodeId=244d158030938, content=<a href='/topic/show?id=eb416989070' target=_blank style='color:#2F92EE;'>#甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69890, encryptionId=eb416989070, topicName=甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=466b16623777, createdName=ms7517674339485982, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1613757, encodeId=e1c91613e5711, content=<a href='/topic/show?id=00fa623901d' target=_blank style='color:#2F92EE;'>#桥本氏甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62390, encryptionId=00fa623901d, topicName=桥本氏甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=250e19422941, createdName=ms3875500703114551, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=920498, encodeId=6f9892049800, content=中医治疗何种为规范?, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Thu Jan 28 07:04:16 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900018, encodeId=361490001863, content=中医治疗桥本方法可以来一篇了,有很好的指导意义!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=0cc51876313, createdName=ms4408957580485341, createdTime=Tue Nov 17 22:40:47 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677281, encodeId=919c16e728109, content=<a href='/topic/show?id=56b36239208' target=_blank style='color:#2F92EE;'>#桥本病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62392, encryptionId=56b36239208, topicName=桥本病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad7e27471083, createdName=zhishijing, createdTime=Thu Jan 16 15:18:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580309, encodeId=244d158030938, content=<a href='/topic/show?id=eb416989070' target=_blank style='color:#2F92EE;'>#甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69890, encryptionId=eb416989070, topicName=甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=466b16623777, createdName=ms7517674339485982, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1613757, encodeId=e1c91613e5711, content=<a href='/topic/show?id=00fa623901d' target=_blank style='color:#2F92EE;'>#桥本氏甲状腺炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62390, encryptionId=00fa623901d, topicName=桥本氏甲状腺炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=250e19422941, createdName=ms3875500703114551, createdTime=Sun Dec 08 10:18:00 CST 2019, time=2019-12-08, status=1, ipAttribution=)]