甲状腺肿英文

The physiological functions of thyroid gland Synthesize,reserve and secrete thyroxine 3,5,3,5-tetraiodothyronine,T4 3,5,3-triiodothyronine,T3 Synthesis of thyroid hormonesnConcentrates iodine nOrganification:iodine oxidation and its incorporation into tyrosine to form monoiodotyrosine(MIT)and diiodotyrosine(DIT)nCoupling:T4 and T3 arise from the coupling of either 2 DIT residues or 1 MIT and 1 DIT residue(requires thyroid peroxidase)Circulating T4 and T3 nThyroid hormones exist in two forms,free and protein bound nthe free hormone concentration determines the thyroid status irrespective of the total plasma concentrationnthe total hormone is determined by thyroxine-binding globin(TGB)and albumin.The thyroid cell has ability to concentrate iodine,therefore,the station of thyroid gland can be judged by checking iodine uptake Thyroid peroxidase plays an important role in the course of organification and coupling.Compounds that inhibited the activity of thyroid peroxidase can be used in the treatment of patients with hyperthyroidism.SignificanceIncreased TBG1.Pregnancy2.Treatmentwithsupraphysiologicamountsofestrogens,雌激素类includingoralcontraceptives.口服避孕药3.InsomepatientswithcirrhosisoracutehepatitisDecreased TBG1.Proteinmalnutrition,hepaticfailure,chronicillness2.Nephroticsyndrome3.Duringtreatmentwithandrogenicsteroids雄激素orpharmacologic药理学dosesofglucocorticoidsthyroxine-binding globin(TGB)Tests of thyroid function nMeasurement of total serum thyroid hormone concentrations nSerum free T4 and T3 concentrations nRadioactive iodine uptake3h24hPeaknormal5%-25%20%-45%24h hypothalamuspituitaryThyroid glandTRHTSH T3 T4Small dose iodoineLarge dose iodine甲状腺激素分泌的调甲状腺激素分泌的调节节nSerum thyrotropin Tests of thyroid regulationAnatomic evaluation of the thyroid glandThe thyroid scan Thyroid ultrasound Needle biopsy Other tests specifically related to thyroid function or diseaseAnti-thyroid antibodies thyroid microsomal antibody(TMAb)thyroglobulin antibodies(TgAb)thyroid TSH receptor(TRAbs)The roles of thyroid hormones regulatetissuemetabolismcentralnervoussystemdevelopmentgrowthandbonematurationGoiterEpithelial cells benign hyperplasia,non inflammation and non tumor Nontoxic goiter(simple goiter):euthyroid甲状腺机能正常的Classification:endemic sporadic compensatoryToxic goiter:hyperthyroidismDiagnosis thyroid gland intumescence 肿大(diffuse or/and nodular)，the function of thyroid gland normal,antibodies against oneself are negativeDifferential diagnosisAutoimmune thyroiditis：antibodies are positive如桥本氏炎如桥本氏炎 Thyroid cancerEtiology and pathogenesisThyroid gland intumescenceT3 T4 tend to normal endemic goiter：iodine deficiencyIodine deficiency TH insufficience TSH Etiology and pathogenesisSporadic goiter1.diet iodineSubstances leading thyroid gland intumescence2.2.drugs3.3.heredity4.4.immunity阻止碘吸收及抑制甲状腺素分泌的物阻止碘吸收及抑制甲状腺素分泌的物质质 如水中的钙和氟、硼、硅如水中的钙和氟、硼、硅 等等卷心菜、甘蓝、芹菜中含有硫氰酸盐卷心菜、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或有机氯酸盐，能够妨碍碘向甲状腺集聚。集聚。磺胺类药、硫脲类药，锂、钴等磺胺类药、硫脲类药，锂、钴等能抑制碘离子的浓集或碘离子有能抑制碘离子的浓集或碘离子有机化。机化。照影剂，含碘药物等照影剂，含碘药物等甲状腺激素合成障碍甲状腺激素合成障碍检测出一种自身抗体检测出一种自身抗体 “甲状甲状腺生长免疫球蛋白腺生长免疫球蛋白”可刺激甲可刺激甲状腺增生肿大。状腺增生肿大。Clinical manifestations Simple thyroid gland intumescence，usually asymptomatic，sever intumescence can cause press symptome I:diameter9cmT3、T4、TSH normalRadioactive iodine uptake increase,but the time of peak dose not move forewardThyroid globulin increaseAntibodies to thyroid are negativeDiagnosis and differential diagnosisnDiagnosis thyroid gland intumescence(diffuse or/and nodular)，the function of thyroid gland normal,antibodies against oneself are negativenDifferential diagnosis Autoimmune thyroiditis：antibodies are positive Thyroid cancer