甲状腺肿英文

甲状腺肿英文第1页/共14页Thephysiologicalfunctionsofthyroidgland

Synthesize,reserveandsecretethyroxine第2页/共14页SynthesisofthyroidhormonesConcentratesiodineOrganification:iodineoxidationanditsincorporationintotyrosinetoformmonoiodotyrosine(MIT)anddiiodotyrosine(DIT)Coupling:T4andT3arisefromthecouplingofeither2DITresiduesor1MITand1DITresidue(requiresthyroidperoxidase)

第3页/共14页CirculatingT4andT3

Thyroidhormonesexistintwoforms,freeandproteinboundthefreehormoneconcentrationdeterminesthethyroidstatusirrespectiveofthetotalplasmaconcentrationthetotalhormoneisdeterminedbythyroxine-bindingglobin(TGB)andalbumin.第4页/共14页Thethyroidcellhasabilitytoconcentrateiodine,therefore,thestationofthyroidglandcanbejudgedbycheckingiodineuptakeThyroidperoxidaseplaysanimportantroleinthecourseoforganificationandcoupling.Compoundsthatinhibitedtheactivityofthyroidperoxidasecanbeusedinthetreatmentofpatientswithhyperthyroidism.Significance第5页/共14页IncreasedTBG1.

Pregnancy2.

Treatmentwithsupraphysiologicamountsofestrogens,雌激素类includingoralcontraceptives.口服避孕药3.

Insomepatientswithcirrhosisoracutehepatitis

DecreasedTBG1.Proteinmalnutrition,hepaticfailure,chronicillness2.Nephroticsyndrome3.Duringtreatmentwithandrogenicsteroids雄激素orpharmacologic药理学dosesofglucocorticoidsthyroxine-bindingglobin(TGB)第6页/共14页Testsofthyroidfunction

MeasurementoftotalserumthyroidhormoneconcentrationsSerumfreeT4andT3concentrationsRadioactiveiodineuptake3h24hPeaknormal5%-25%20%-45%24h第7页/共14页

hypothalamuspituitaryThyroidglandTRH＋TSH

＋T3T4－－SmalldoseiodoineLargedoseiodine＋－甲状腺激素分泌的调节第8页/共14页SerumthyrotropinTestsofthyroidregulationAnatomicevaluationofthethyroidglandThethyroidscanThyroidultrasoundNeedlebiopsy

OthertestsspecificallyrelatedtothyroidfunctionordiseaseAnti-thyroidantibodiesthyroidmicrosomalantibody(TMAb)thyroglobulinantibodies(TgAb)thyroidTSHreceptor(TRAb’s)

第9页/共14页Therolesofthyroidhormones

regulatetissuemetabolism

centralnervoussystemdevelopmentgrowthandbonematurationGoiterEpithelialcellsbenignhyperplasia,noninflammationandnontumorNontoxicgoiter(simplegoiter):euthyroid甲状腺机能正常的Classification:endemicsporadiccompensatoryToxicgoiter:hyperthyroidismDiagnosis

thyroidglandintumescence肿大(diffuseor/andnodular)，thefunctionofthyroidglandnormal,antibodiesagainstoneselfarenegativeDifferentialdiagnosisAutoimmunethyroiditis：antibodiesarepositive如桥本氏炎

Thyroidcancer第10页/共14页EtiologyandpathogenesisThyroidglandintumescenceT3T4tendtonormal

endemicgoiter：iodinedeficiencyIodinedeficiency

THinsufficience

TSH

第11页/共14页EtiologyandpathogenesisSporadicgoiter1.diet

iodineSubstancesleadingthyroidglandintumescence2.drugs3.heredity4.immunity阻止碘吸收及抑制甲状腺素分泌的物质如水中的钙和氟、硼、硅等卷心菜、甘蓝、芹菜中含有硫氰酸盐或有机氯酸盐，能够妨碍碘向甲状腺集聚。磺胺类药、硫脲类药，锂、钴等能抑制碘离子的浓集或碘离子有机化。照影剂，含碘药物等甲状腺激素合成障碍检测出一种自身抗体“甲状腺生长免疫球蛋白”可刺激甲状腺增生肿大。第12页/共14页Clinicalmanifestations

Simplethyroidglandintumescence，usuallyasymptomatic，severintumescencecancausepresssymptomeI:diameter<3cmII:diameter3-5cmIII:diameter5-7cmIV:diameter7-9cmV:diameter>9cmLaboratoryfindings