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目的探讨99mTcO4-甲状腺动静态显像对桥本氏甲状腺炎(慢性淋巴细胞性甲状腺炎,以下简称HT)的诊断价值。方法选取78例临床诊断为HT患者,其中70例经针刺细胞学确诊,8例手术病理确诊,而且2例术后病理明确为HT合并甲状腺乳头状癌;并选取30例健康人为对照组,两组人员均进行甲状腺动静态显像、化学发光法游离甲状腺激素(FT3、FT4),血清超敏TSH(TSH-ul)、甲状腺球蛋白抗体及甲状腺过氧化物酶抗体(TGAb及TPOAb)测定,并根据甲状腺激素水平将HT分为:功能减退组、亚临床甲减组、功能正常组、功能亢进组,分析摄锝率、有无结节、动态血流与甲状腺激素水平及甲状腺相关抗体间的关系,各组与对照组比较,采用统计软件SPSS16.0软件,χ2检验。结果 78例桥本氏甲状腺炎中60例(76.92%)以核素放射性弥漫性高摄取表现,10例(13%)以放射性核素分布大致均匀,摄锝率在正常范围表现,8例(10.26%)以核素放射性分布不均匀,“结节”表现,57例(73.01%)甲状腺相关抗体增高,而对照组30例均为放射性核素分布大致均匀,摄锝率在正常范围表现。结论 HT患者甲状腺摄取功能在不同激素水平间表现出复杂特点,甲状腺动静态显像在桥本氏病诊断与鉴别诊断中具有一定价值。
Objective To investigate the diagnostic value of 99mTcO4-thyroid dynamic and static imaging for Hashimoto’s thyroiditis (chronic lymphocytic thyroiditis, hereinafter referred to as HT). Methods Seventy eight patients diagnosed as HT were selected, of which 70 were diagnosed by acupuncture cytology and 8 were pathologically confirmed. Two patients were diagnosed as HT with papillary thyroid carcinoma. Thirty healthy controls were selected as control group, Thyroid dynamic imaging and chemiluminescence immunoassay (FT3, FT4), serum TSH (TSH-ul), thyroglobulin antibody and thyroid peroxidase antibody (TGAb and TPOAb) were performed in both groups. According to the level of thyroid hormone, HT was divided into hypothyroidism group, subclinical hypothyroidism group, normal function group and hyperthyroidism group. The rate of uptake of technetium, presence of nodules, dynamic blood flow and thyroid hormone level and thyroid-related antibody The relationship between each group and the control group, the use of statistical software SPSS16.0 software, χ2 test. Results 78 cases of Hashimoto’s thyroiditis in 60 cases (76.92%) radionuclide diffuse high uptake performance, 10 cases (13%) with radionuclide distribution is roughly uniform, the rate of uptake of DNA in the normal range, 8 cases ( 10.26%) showed uneven distribution of radionuclide, “nodules”, 57 cases (73.01%) of thyroid-related antibodies increased, while the control group of 30 cases were radionuclide distribution is roughly uniform, the rate of uptake of technetium in the normal range which performed. Conclusion The uptake of thyroid function in HT patients shows complex characteristics in different hormone levels. Dynamic and static thyroid imaging has some value in the diagnosis and differential diagnosis of Hashimoto’s disease.