- 期刊
甲狀腺功能亢進常見原因與臨床處置
Common Causes and Clinical Management of Hyperthyroidism
摘要
甲狀腺功能亢進（hyperthyroidism，簡稱甲亢）是指甲狀腺過度合成甲狀腺激素並釋放到血液中，是引起甲狀腺毒症的原因之一，其中又以葛瑞夫茲氏病最為常見。甲亢引發交感神經興奮，進而影響身體各器官系統的表現，導致代謝、心血管系統、皮膚、精神、神經肌肉系統、內分泌系統及骨骼吸收等都受到影響，年長病人經常以非特異性且輕微的症狀表現，伴隨心房纖維顫動的併發症比例也增加。臨床診斷除了依據出現的徵候與症狀外，需追蹤實驗室檢查（如TSH、FT4、T3）或可進一步安排促甲狀腺素受體抗體檢測（Anti-TSH Receptor Ab）、甲狀腺對放射碘攝取量或是甲狀腺超音波幫助釐清病因。甲亢治療的方式有放射碘治療、抗甲狀腺藥物或手術，臨床醫師除了與病人討論選擇最適合的治療方式以外，也需善盡告知應注意事項及衛教的責任。
並列摘要
Hyperthyroidism is a form of thyrotoxicosis in which inappropriately high thyroid hormone is synthesized and secreted by the thyroid gland into the blood. The most common cause of hyperthyroidism is Graves' disease. Hyperthyroidism leads to excess thyroid hormone production, affects the performance of human organ systems, and infleunces the metabolic rate, cardiovascular system, skin, mental status, neuromuscular system, endocrine system, and bone absorption. Older adults generally present nonspecific and mild symptoms. The proportion of atrial fibrillation also increases. Clinical diagnosis of hyperthyroidism is based on appearance of signs and symptoms. Laboratory tests (including TSH, FT4, and T3) should be conducted. Further examinations such as thyrotropin receptor antibodies test, thyroid uptake of radioactive iodine, or thyroid ultrasound may be arranged to help determine the causes of hyperthyroidism. The treatment options for hyperthyroidism include radioactive iodine therapy, antithyroid drugs, and surgery. The physician should inform patients of issues needing attention and offer health education beside discussing and deciding the most appropriate treatment methods with the patients.