Hyperthyroidism

Introduction Hyperthyroidism is the abbreviation of hyperthyroidism. It refers to the clinical manifestation of thyroid function enhancement caused by various reasons, excessive secretion of thyroid hormone (TH), resulting in increased systemic excitability and hypermetabolism in the body's nerves, circulation and digestion. Syndrome. Most hyperthyroidism has a slow onset and acute onset. The incidence rate is about 31/100,000. It is more common in women. The ratio of male to female is about 1:4-6. Some 495 patients with hyperthyroidism and 416 females, accounting for 84%. 79 males, accounting for 16%. All age groups can be affected, with more than 20 to 40 years old. The incidence of thyroid disease varies from region to region. The medical school analyzed 30,760 cases of total inpatients in the hospital, 585 cases of thyroid disease, including 203 cases of hyperthyroidism, accounting for 34.7%; 106581 inpatients of the First Affiliated Hospital of Zhongshan Medical College Among them, 2070 cases of thyroid disease, of which 851 cases of hyperthyroidism, accounting for 41.1%. Hyperthyroidism is usually the most common clinical manifestation of diffuse goiter.

Cause

It refers to a common endocrine disease characterized by excessive secretion of thyroid hormone due to various reasons. There are many causes of the disease, including thyroid hyperthyroidism, pituitary hyperthyroidism, drug-induced hyperthyroidism, thyroiditis with hyperthyroidism, familial goiter with hyperthyroidism. The incidence of women is significantly higher than that of men.

(1) thyroid hyperthyroidism, which is further divided into: toxic diffuse goiter (Graves disease); multinodular goiter with nail; autonomic high-function thyroid nodules; thyroid cancer (follicular thyroid cancer); newborn Hyperthyroidism;

(2) pituitary hyperthyroidism, which is further divided into: pituitary tumor (TSH tumor)-induced hyperthyroidism; non-pituitary tumor-induced hyperthyroidism (pituitary TH resistance);

(3) with tumor hyperthyroidism, is divided into: chorionic epithelial cancer with hyperthyroidism; hydatidiform mole with hyperthyroidism; lung cancer, digestive system (stomach, colon, pancreatic) cancer and other hyperthyroidism;

(4) ovarian goiter with hyperthyroidism.

(5) Thyroiditis hyperthyroidism, which is further divided into: subacute thyroiditis; Hashimoto thyroiditis; radiation thyroiditis;

(6) Drug-induced hyperthyroidism.

an examination

Related inspection

Thyroid radionuclide imaging examination thyroid blood flow imaging high density lipoprotein 2-cholesteryl cyclic guanosine monophosphate creatine kinase

Typical clinical manifestations include two major groups of symptoms: increased metabolism of thyroxine and neurological excitability.

1. Increased metabolic rate. It is characterized by excessive appetite, weight loss, increased heart rate, fatigue, weakness, heat, skin warmth, dampness and sweating, chest tightness, shortness of breath, diarrhea, and other symptoms.

2, nervous excitement. Often manifested as nervous, temperament, impatience, irritability, insomnia and more dreams. In severe cases, symptoms such as depression and arrogance may occur.

In short, the diagnosis of this disease is not difficult, if the clinical manifestations of palpitations, spontaneous sweating, increased appetite and weight loss, emotional irritability, hand shake, eyeballs and thyroid enlargement, a preliminary diagnosis can be made.

Differential diagnosis

1 neurosis, its neurological and psychiatric symptoms may be similar, but this disease has no hyperthyroidism with hyperthyroidism, appetite is not hyperthyroidism, heart rate is normal after falling asleep, no goiter and exophthalmos, if necessary, check thyroid function.

2 Simple goiter has goiter but no symptoms and signs of hyperthyroidism. The peak rate of 131I is not advanced, and serum total thyroxine is not increased.

3 other weight loss, low fever should be identified with tuberculosis, tumor, diarrhea and chronic colitis, palpitations, arrhythmia and rheumatic heart disease, coronary heart disease identification.

The diagnosis of this disease is not difficult. If the clinical manifestations are palpitations, spontaneous sweating, increased appetite and weight loss, emotional irritability, hand shaking, eyeball protrusion and goiter, a preliminary diagnosis can be made.

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