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2012 ATA 成人甲状腺功能减退症新版临床实践指南发布

2012-10-02 MedSci MedSci原创

 近日,美国甲状腺协会(American Thyroid Association ,ATA)和美国内分泌医师协会(American Association of Clinical Endocrinologists ,AACE)共同制定了新的甲状腺机能减退症的治疗和诊断循证指南。该指南在线发表于9月12日《甲状腺》杂志(Thyroid)。 ATA和AACE工作小组回顾了医学文献和现行治

 近日,美国甲状腺协会(American Thyroid Association ,ATA)和美国内分泌医师协会(American Association of Clinical Endocrinologists ,AACE)共同制定了新的甲状腺机能减退症的治疗和诊断循证指南。该指南在线发表于9月12日《甲状腺》杂志(Thyroid)。


ATA和AACE工作小组回顾了医学文献和现行治疗标准,建议更新甲状腺功能减退症诊疗指南,该指南的主要作者是哈佛先锋医学中心和波士顿贝斯以色列女执事医疗中心杰弗里·加伯博士和他的同事。

ATA主席James A. Fagin医学博士说:“指南委员会的成员应该得到祝贺,因为他们提供了科学的、最新的甲状腺功能低下的诊断和治疗指南,为临床医生如何处理这个共同的临床问题,提供了实用的建议。”

马萨诸塞州医学院名誉教授、Thyroid杂志首席编辑Charles H. Emerson博士认为,本指南针对的是临床医生在治疗疾病中遇到的危害到数百万男性甚至更多女性的广泛问题。他们认真处理和解决甲状腺激素应用不当的问题,考虑到不应该服用甲状腺激素的人,以及应用不理想或危险剂量的甲状腺功能减退患者。”

指南对初级保健医师,提出一下几点:

1、临床医师在治疗甲状腺功能减退症的婴儿和儿童患者、已怀孕或打算怀孕的女性、心​​脏疾病的患者,合并其他内分泌疾病(如肾上腺或垂体疾病)时,应咨询内分泌科专家。已有甲状腺肿大,结节或甲状腺的结构变化或一项“甲状腺功能检查结果不正常的患者也应该咨询内分泌医师。

2、尽管血清促甲状腺激素(TSH)试验是甲状腺功能减退症最好的筛查试验,但临床医生应该知道,仅依靠TSH试验不足以评估住院患者是否存在甲状腺功能减退。

3、甲状腺功能减退症的标准治疗方法是甲状腺素替代治疗,但目前还没有临床数据支持的柜台所售该类药物的临床疗效。

4、左旋甲状腺素和左旋三碘甲状腺氨酸组合不推荐应用于已怀孕或试图怀孕的妇女。

5、中老年人轻度TSH升高可能是正常老化的表现,不一定是甲状腺功能减退。

编译自:
1、New Clinical Guidelines For Managing Hypothyroid Disease Presented In Thyroid Journal, Medicalnewstoday,2012-9-14
2、Hypothyroidism Evaluation and Treatment Guidelines Released,Medscape,2012-9-14

编后语:
该文章是在提前发表Thyroid杂志的,指南最终版本尚未发布,最终版本与该版可能会有些许变化,我们会在第一时间将最终版本上传,敬请期待!

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    2013-01-17 Dady

    A really good answer, full of ratoianlity!

    0

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  3. [GetPortalCommentsPageByObjectIdResponse(id=5378, encodeId=89f953e8d6, content=A really good answer, full of ratoianlity!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Dady, createdTime=Thu Jan 17 05:02:00 CST 2013, time=2013-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030969, encodeId=84dc203096983, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sun Jan 06 03:02:00 CST 2013, time=2013-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323588, encodeId=02a91323588d1, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465984, encodeId=545514659842e, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571919, encodeId=ca6915e19195a, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=5378, encodeId=89f953e8d6, content=A really good answer, full of ratoianlity!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Dady, createdTime=Thu Jan 17 05:02:00 CST 2013, time=2013-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030969, encodeId=84dc203096983, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sun Jan 06 03:02:00 CST 2013, time=2013-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323588, encodeId=02a91323588d1, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465984, encodeId=545514659842e, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571919, encodeId=ca6915e19195a, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=)]
    2012-10-04 bbjsj_1981
  5. [GetPortalCommentsPageByObjectIdResponse(id=5378, encodeId=89f953e8d6, content=A really good answer, full of ratoianlity!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Dady, createdTime=Thu Jan 17 05:02:00 CST 2013, time=2013-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030969, encodeId=84dc203096983, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sun Jan 06 03:02:00 CST 2013, time=2013-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323588, encodeId=02a91323588d1, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465984, encodeId=545514659842e, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571919, encodeId=ca6915e19195a, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Thu Oct 04 14:02:00 CST 2012, time=2012-10-04, status=1, ipAttribution=)]
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