Abstract:

Objective:To discuss the evolution of hyperthyroidism under different iodine circumstances,and give a summary of transition,such as etiologic factor and methods of diagnosis and treatment. Methods:Clinical data of 5 365 cases of thyroidism admitted from 1960 to 2005 were analyzed retrospectively. Results:A decreasing trend of Graves’ Diseases was from 88.5% in 1960s to 36.5% in recent 5 years,while an increasing trend of secondary hyperthyroidism was from 11.2% in 1960s to 63.5% in recent 5 years.Cases of hyperthroidism initiated by thyroiditis and iodine appeared more regularly than that first appeared 25 years ago. Conclusion:The etiologic factor of hyperthyroidism changes from Graves’disease to secondary hyperthroidism and iodineinduced hyperthroidism.The transition of diagnosis is from clinical manifestation,basal metablic rate and absorption rate of iodine to color displaying Doppler ultrasonic tomograph and functional test of thyroid.Simple medicine treatment of hyperthyroidism is replaced by combination of drug and surgery,and the latter has taken half of all.

Key words: Hyperthyroidism, Graves Disease, Toxic nodular goiter, Thyroidectomy

摘要：

目的:探讨在各个历史时期不同的碘环境下甲状腺功能亢进(甲亢)的演变趋向，总结其原发疾病及诊断治疗手段的变迁。方法:回顾性分析1960-2005年5 365例诊断为甲亢的临床资料。结果:统计Graves病与继发性甲亢20世纪60年代分别占88.5%和11.2％；近5年分别占36.5%和63.5%。甲状腺炎性疾病和碘引发的甲亢在25年前出现，并有增加趋势。结论:随年代变迁，甲亢的引发疾病从Graves病为主逐渐转变为继发性甲亢、甲状腺炎伴甲亢；诊断方法以临床症状、基础代谢率、吸碘率为主过渡到彩色多普勒超声及甲状腺功能检查；治疗方法从单纯抗甲状腺药发展至药物与手术联合应用，手术治疗病例已占1/2。

关键词: 甲状腺功能亢进, Graves病, 毒性结节性甲状腺肿, 甲状腺切除术