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目的:探讨超声在亚临床甲状腺功能减退诊断中的应用,为亚临床甲状腺功能减退的诊断提供参考。方法:选取2015年6月至2016年3月在东莞市东莞三局医院就诊的50例亚临床甲状腺功能减退症患者分为甲减组作为观察组,同期就诊的50例甲状腺功能亢进患者分为甲亢组和50例甲状腺功能正常者正常组作为两个对照组。对3组患者进行多普勒超声检查,对比3组观察对象的甲状腺体积、甲状腺回声信号强度及甲状腺血流信号(包括PSV、T、HR、T/HR、RI)。并比较甲减组中不同类型的亚临床甲状腺功能减退的超声图像表现。结果:亚临床甲状腺功能减退患者的甲状腺体积较正常肿大明显,但不及甲状腺功能亢进患者,差异具有统计学意义(P<0.05);甲状腺回声信号强度方面,正常组有14例回声信号增强,甲亢组45例回声信号增强,甲减组38例回声信号增强,甲减组患者中甲状腺回声信号增强的比例明显高于正常组,但不及甲亢组,差异具有统计学意义(P<0.05);甲减组患者甲状腺血流信号丰富,甲状腺上动脉最大血流速度(PSV)高于正常组,低于甲亢组(P<0.05),收缩期达峰时间(T)及T/HR指数均明显高于甲亢组差异具有统计学意义(P<0.05)。在甲减组中,各类型亚临床甲状腺功能减退的超声表现无明显特异性,不同类型即表现为不同的声像特征。结论:超声检查在亚临床甲状腺功能减退的诊断及鉴别中有重要意义。
Objective: To explore the application of ultrasound in the diagnosis of subclinical hypothyroidism and provide a reference for the diagnosis of subclinical hypothyroidism. Methods: Fifty hypothyroidism hypothyroidism patients treated in Dongguan Third Hospital from June 2015 to March 2016 were divided into hypothyroidism group as the observation group. Fifty patients with hyperthyroidism during the same period were divided into Hyperthyroidism group and 50 cases of normal thyroid function normal group as two control groups. The Doppler echocardiography was used to compare the thyroid volume, thyroid echo signal intensity and thyroid blood flow signal (including PSV, T, HR, T / HR, RI) in the three groups. And compared the different types of subclinical hypothyroidism in hypothyroidism ultrasound image performance. Results: The volume of thyroid in subclinical hypothyroidism was significantly higher than that in normal thyroid, but not in patients with hyperthyroidism (P <0.05). In thyroid echo signal intensity, there were 14 cases of echo signal enhancement in normal group, In the hyperthyroidism group, the echo signal was enhanced in 45 cases, the echo signal was enhanced in 38 cases of hypothyroidism group, the proportion of thyroid hypoechoic signal enhancement in hypothyroidism group was significantly higher than that in normal group, but not as high as that in hyperthyroid group (P <0.05). In hypothyroidism group, the thyroid blood flow signal was abundant, and the maximum thyroid artery blood flow velocity (PSV) was higher than that in normal group and hyperthyroidism group (P <0.05). The systolic peak time (T) and T / HR index The difference was statistically significant (P <0.05) higher than hyperthyroidism group. In the hypothyroidism group, there was no obvious specificity of the ultrasound manifestations of various subclinical hypothyroidism. Different types showed different acoustic imaging features. Conclusion: Ultrasonography is of great importance in the diagnosis and differentiation of subclinical hypothyroidism.