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高碘性甲状腺肿是由于摄入过量的碘而诱发的甲状腺肿,其病因与缺碘性甲状腺肿迥异。本文两例因服乙胺碘呋酮而诱发,报告于下。 1 临床资料 例1:女,35岁。因病毒性心肌炎,心律失常,曾服乙胺碘呋酮3月(总量0.2g×90片)。后渐发现甲状腺肿大伴乏力、头昏,无怕热、多汗、食欲亢进及水肿,月经稍增多。体查:营养中等,毛发稍干枯,皮肤略粗糙,无突眼及水肿。甲状腺肿大Ⅱ度,质尚软,无血管杂音。心界不大,心率80次,律齐无杂音。膝反射减弱,反射恢复时间延迟。余无异常发现。TT_3<0.2ng/ml,TT_410ng/ml,TSH60μIU/ml,甲状腺球蛋白抗体(TGA)70％,甲状腺微粒体抗体(TMA)41％,血清皮质醇正常。经用甲状腺片40～80mg/日治疗65天后,患者症状改善,头昏、乏力基本缓解,食欲增加,甲状腺肿减至Ⅰ度,月经正常。复查TT_30.74ng/ml,T_436ng/ml。
High-iodine goiter is due to excessive intake of iodine-induced goiter, its cause and iodine deficiency goiter very different. Two cases of this article due to taking amiodarone and induced, reported in the next. 1 clinical data example 1: female, 35 years old. Due to viral myocarditis, arrhythmia, had taken amiodarone in March (total 0.2g × 90 tablets). Gradually found goiter with fatigue, dizziness, no fear of heat, sweating, hyperostosis and edema, menstruation increased slightly. Physical examination: medium nutrition, hair a little dry, slightly rough skin, no exophthalmos and edema. Goiter Ⅱ degree, quality is still soft, no vascular noise. Heart, heart rate 80 times, law Qi no noise. Reduced knee reflex, delayed reflex recovery time. I found no abnormalities. TT_3 <0.2ng / ml, TT_410ng / ml, TSH60μIU / ml, thyroglobulin antibody (TGA) 70%, thyroid microsomal antibody (TMA) 41%, serum cortisol normal. Thyroid tablets by 40 ~ 80mg / day 65 days after treatment, the patient’s symptoms improved, dizziness, fatigue, basic relief, increased appetite, goiter grade I, normal menstruation. Review TT_30.74ng / ml, T_436ng / ml.