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自主功能性甲状腺结节(autonomously functioning thyroid nodule,AFTN)发生于甲状腺腺体,是一种能引起甲状腺毒症的疾病,99%的AFTN为良性,可单发也可多发[1]。随着结节的增大,AFTN的自主功能逐渐变强,患者可逐步表现为甲状腺功能正常、亚临床甲状腺功能亢进症(简称甲亢)(毒性结节前期)和临床甲亢(毒性结节期)。AFTN的诊断通常是根据患者的症状、体征,结合实验室检查以及影像学检查来确定的。AFTN的治疗方法有手术、131I治疗、抗甲状腺药物(antithyroid drug,ATD)治疗、射频消融(radiofrequency ablation,RFA)治疗等,治疗方法各有优劣。本文对AFTN的发病机制、诊断与131I治疗等综述如下。
自主功能性甲状腺结节的诊断与131I治疗进展
Advances in diagnosis and 131I therapy of autonomously functioning thyroid nodule
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摘要: 自主功能性甲状腺结节(AFTN)是一种能引起甲状腺毒症的疾病,结节可单发也可多发,其中99%为良性,多发生在甲状腺的2个侧叶,峡部少见。AFTN的治疗方法有手术、131I治疗、抗甲状腺药物治疗、射频消融治疗等。其中131I治疗是一种治疗AFTN的有效方法。笔者结合国内外文献报道,对AFTN的发病机制与诊断方法,以及131I治疗的原理、临床应用与疗效等作一综述,为AFTN的临床诊疗提供参考。
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关键词:
- 碘放射性同位素 /
- 自主功能性甲状腺结节 /
- 放射疗法 /
- 甲状腺功能亢进症
Abstract: Autonomously functioning thyroid nodule (AFTN) is a disease that can cause thyrotoxicosis. Nodules can be solitary or multiple, with 99% of them being benign and occurring mostly in the two lateral lobes of the thyroid gland. The isthmus is rare. The treatment methods for AFTN include surgery, 131I therapy, antithyroid drug, and radiofrequency ablation. 131I therapy is an effective treatment for AFTN. Based on domestic and foreign literature reports, the authors review the pathogenesis and diagnosis of AFTN, as well as the principle, clinical application and efficacy of 131I therapy, so as to provide reference for clinical diagnosis and treatment of AFTN. -
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