徐华英

[摘要] 目的 探讨超声对于甲状腺功能亢进症与桥本氏甲状腺炎的鉴别诊断效果。方法 回顾性分析2018年11月—2019年11月该院72例甲状腺功能亢进症（甲亢组）与78例桥本氏甲状腺炎（桥本组）患者的临床资料。两组患者均通过彩色多普勒超声设备进行甲状腺检查，对比两组超声表现与彩色多普勒参数指标。结果 桥本组甲状腺峡部增厚、合并结节、内部网络样回声、颈部Ⅳ区与Ⅵ区淋巴结肿大的发生率70.51%、32.05%、89.74%、41.03%均高于甲亢组11.11%、16.67%、18.06%、19.44%，差异有统计学意义（χ2=54.232，4.769，77.850，8.201，P<0.05）;甲亢组甲状腺上下径增大的发生率75.00%高于橋本组10.26%，差异有统计学意义（χ2=64.720，P<0.01）。桥本组彩色多普勒参数T（68.05±14.02）s与RI（0.65±0.12）高于甲亢组（51.85±10.17）s与（0.58±0.10），差异有统计学意义（t=8.043，3.864，P<0.001）;桥本组EDV（21.52±5.36）cm/s与PSV（57.62±20.44）cm/s低于甲亢组（34.52±6.15）cm/s与（103.52±19.52）cm/s，差异有统计学意义（t=13.828，18.301，P<0.01）。结论 超声对于甲状腺功能亢进症与桥本氏甲状腺炎具有显著的鉴别诊断效果，为临床诊疗方案提供了重要的影像学依据。

[关键词] 超声;甲状腺功能亢进症;桥本氏甲状腺炎;鉴别诊断

[中图分类号] R445.1;R581          [文献标识码] A          [文章编号] 1674-0742（2020）08（c）-0186-03

[Abstract] Objective To investigate the effect of ultrasound on the differential diagnosis of hyperthyroidism and Hashimoto's thyroiditis. Methods The clinical data of 72 patients with hyperthyroidism （hyperthyroidism group） and 78 patients with Hashimoto's thyroiditis （Hashimoto's group） in the hospital from November 2018 to November 2019 were retrospectively analyzed. Both groups of patients were examined by color Doppler ultrasound equipment， and the ultrasound performance and color Doppler parameters of the two groups were compared. Results The incidence of thickening of the thyroid isthmus， combined nodules， internal network echo， and cervical area IV and VI lymphadenopathy in the Hashimoto group was 70.51%， 32.05%， 89.74%， and 41.03% higher than those in the hyperthyroidism group by 11.11%， 16.67%， 18.06%， 19.44%，the difference was statistically significant（χ2=54.232， 4.769， 77.850， 8.201， P<0.05）; the incidence of increased thyroid diameter in the hyperthyroidism group was 75.00% higher than that in the Hashimoto group 10.26%，the difference was statistically significant（χ2=64.720， P<0.01）. The color Doppler parameters T （68.05±14.02）s and RI （0.65±0.12） of Hashimoto group were higher than those of hyperthyroidism group （51.85±10.17）s and （0.58±0.10），the difference was statistically significant（t=8.043， 3.864， P<0.001）; EDV（21.52±5.36） cm/s and PSV （57.62±20.44）cm/s in the Hashimoto group were lower than those in the hyperthyroidism group （34.52±6.15） cm/s and （103.52±19.52）cm/s，the difference was statistically significant（t=13.828， 18.301， P<0.01）. Conclusion Ultrasound has a significant differential diagnosis effect on hyperthyroidism and Hashimoto's thyroiditis， and provides important imaging evidence for clinical diagnosis and treatment.

[Key words] Ultrasound; Hyperthyroidism; Hashimoto's thyroiditis; Differential diagnosis

桥本氏甲状腺炎是一种以自身甲状腺组织为抗原的自身慢性免疫性疾病，该病无特异性的临床症状与体征，多数患者可伴有甲状腺功能异常[1]。甲状腺功能亢进则是甲状腺腺体本身大量形成甲状腺激素所致的一种甲状腺毒症[2]。目前，超声是诊断甲状腺疾病的重要影像学手段，然而甲状腺功能亢进症与桥本氏甲状腺炎在超声中存在诸多相似之处，加之两者临床表现相近，均可以出现甲状腺代谢异常与腺体肿大，所以临床鉴别诊断难度较高[3]。该研究通过回顾性分析2018年11月—2019年11月该院72例甲状腺功能亢进症与78例桥本氏甲状腺炎患者的临床资料，观察并对比两种疾病的超声表现，以期为临床鉴别诊断方案提供可靠的参考，现报道如下。

1  资料与方法

1.1  一般资料

回顾性分析该院72例甲状腺功能亢进症与78例桥本氏甲状腺炎患者的临床资料，其中甲状腺功能亢进症组作为甲亢组，桥本氏甲状腺炎作为桥本组。……