指南解读
ENGLISH ABSTRACT
2016版美国甲状腺协会《甲状腺功能亢进症和其他原因所致甲状腺毒症诊治指南》解读:核医学部分
蒋宁一
作者及单位信息
·
DOI: 10.3760/cma.j.issn.2095-2848.2018.05.001
Interpretation of 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis: nuclear medicine part
Jiang Ningyi
Authors Info & Affiliations
Jiang Ningyi
Department of Nuclear Medicine, Sun Yet-Sen Memorial Hospital, Sun Yet-Sen University, Guangzhou 510289, China
·
DOI: 10.3760/cma.j.issn.2095-2848.2018.05.001
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摘要

2016年美国甲状腺协会(ATA)新版《甲状腺功能亢进症和其他原因所致甲状腺毒症诊治指南》中循证推荐数目增至124个(2011版指南中有100个),更加细化了甲状腺疾病的诊断、治疗方案。 131I为治疗格雷夫斯病(GD)的一种重要方法,新版指南中对其作了详尽的叙述,包括应用指征、剂量确定、防护措施及在儿童中合理应用等。该文对新版指南中核医学部分内容进行解读,重点解读其中更新的内容。

甲状腺毒症;甲状腺功能亢进症;实践指南;核医学;美国
ABSTRACT

The new American Thyroid Association (ATA) guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis was published in 2016. Compared to the 100 pieces of evidence-based recommendations in 2011 edition guidelines, the 2016 edition guidelines included 124 pieces of evidence-based recommendations, which made the diagnosis and therapy of thyroid diseases more detailed. As one of the most important treatment for Graves disease (GD), 131I therapy was explained more completely in the 2016 edition guidelines, including the indication, the determination of dose, the radiation protection, the reasonable application in children and so on. The purpose of this paper is to interpret the 2016 edition guidelines about the diagnosis and therapy of thyroid diseases in the view of nuclear medicine, focusing on the updated contents.

Thyrotoxicosis;Hyperthyroidism;Practice guidelines;Nuclear medicine;United States
Jiang Ningyi, Email: mocdef.mabot.pivjiygnin
Special Public Welfare Project of the Ministry of Science and Technology (200802028)
引用本文

蒋宁一. 2016版美国甲状腺协会《甲状腺功能亢进症和其他原因所致甲状腺毒症诊治指南》解读:核医学部分[J]. 中华核医学与分子影像杂志,2018,38(5):305-310.

DOI:10.3760/cma.j.issn.2095-2848.2018.05.001

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有关甲状腺毒症方面的研究仍然是多学科关注的热点。2011年,美国甲状腺协会(American Thyroid Association, ATA)联合美国临床内分泌医师协会(American Association of Clinical Endocrinologists, AACE)在总结循证医学证据及有关文献更新的基础上,联合发布了甲状腺毒症的诊治指南,用于指导全科医师、专科医师和其他为甲状腺毒症患者提供医疗服务的人员更新理念,实施合理和较佳的诊治策略。其后,甲状腺毒症方面的新研究不断涌现,因此ATA在2016年又推出了更新版《甲状腺功能亢进症和其他原因所致甲状腺毒症诊治指南》。
在使用新版指南时,有必要注意以下几点:第一,该指南明确指出,其提供的各推荐项,尤其是推荐级别较低的项目,必须在结合临床判断、患者及家属意愿的基础上实施。第二,由于对某些问题尚缺乏高质量的循证依据,指南中部分推荐条款的推荐强度与其证据质量并不平行;也就是说,某些强烈推荐并非来自高质量证据,仍有继续研究的空间。第三,该指南由ATA组织编写,其考虑的国情、医疗、保险和卫生经济学背景绝大部分源自美国社会,由此产生的某些理念并不适合直接照搬或强行推广到其他国家和地区。
本系列论文分别从核医学、内科及外科角度对ATA 2016年新版指南进行解读,涉及甲状腺功能亢进症常见原因格雷夫斯病(Graves disease, GD)和其他原因所致甲状腺毒症的诊治处理。
格雷夫斯病(Graves disease, GD)是引起甲状腺功能亢进症(简称甲亢)最常见的原因, 131I治疗仍然是常用的一种GD治疗方法。2016版美国甲状腺协会《甲状腺功能亢进症和其他原因所致甲状腺毒症诊治指南》(简称2016版指南) [ 1 ]对甲亢及其他原因所致甲状腺毒症的 131I治疗进行了更加详细的讨论与阐述。下面主要对2016版指南 [ 1 ]中有关 131I治疗相关内容进行解读。
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参考文献
[1]
Ross DS , Burch HB , Cooper DS ,et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis[J]. Thyroid, 2016,2610):1343-1421. DOI: 10.1089/thy.2016.0229 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Bahn Chair RS , Burch HB , Cooper DS ,et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists[J]. Thyroid, 2011,216):593-646. DOI: 10.1089/thy.2010.0417 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
中华医学会核医学分会. 131I治疗格雷夫斯甲亢指南(2013版) [J]. 中华核医学与分子影像杂志, 2013,332):83-95. DOI: 10.3760/cma.j.issn.2095-2848.2013.02.002 .
返回引文位置Google Scholar
百度学术
万方数据
Chinese Society of Nuclear Medicine. Clinical guidelines for 131I treatment of Graves hyperthyroidism [J]. Chin J Nucl Med Mol Imaging, 2013,332):83-95. DOI: 10.3760/cma.j.issn.2095-2848.2013.02.002 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[4]
Stokkel MP , Handkiewicz Junak D , Lassmann M ,et al. EANM procedure guidelines for therapy of benign thyroid disease[J]. Eur J Nucl Med Mol Imaging, 2010,3711):2218-2228. DOI: 10.1007/s00259-010-1536-8 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Silberstein EB , Alavi A , Balon HR ,et al. The SNMMI practice guideline for therapy of thyroid disease with 131I 3 .0[J ]. J Nucl Med, 2012,5310):1633-1651. DOI: 10.2967/jnumed.112.105148 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Walter MA , Briel M , Christ-Crain M ,et al. Effects of antithyroid drugs on radioiodine treatment: systematic review and meta-analysis of randomised controlled trials[J]. BMJ, 2007,3347592):514. DOI: 10.1136/bmj.39114.670150.BE .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Azizi F , Smyth P ,et al. Breastfeeding and maternal and infant iodine nutrition[J]. Clin Endocrinol (Oxf), 2009,705):803-809. DOI: 10.1111/j.1365-2265.2008.03442.x .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Kobe C , Eschner W , Sudbrock F ,et al. Graves′ disease and radioiodine therapy. Is success of ablation dependent on the achieved dose above 200 Gy?[J]. Nuklearmedizin, 2008,471):13-17.
返回引文位置Google Scholar
百度学术
万方数据
[9]
Ross DS , Daniels GH , De Stefano P ,et al. Use of adjunctive potassium iodide after radioactive iodine ( 131I) treatment of Graves′ hyperthyroidism [J]. J Clin Endocrinol Metab, 1983,572):250-253. DOI: 10.1210/jcem-57-2-250 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Jaiswal AK , Bal C , Damle NA ,et al. Comparison of clinical outcome after a fixed dose versus dosimetry-based radioiodine treatment of Graves′ disease: results of a randomized controlled trial in Indian population[J]. Indian J Endocrinol Metab, 2014,185):648-654. DOI: 10.4103/2230-8210.139222 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Alexander EK , Larsen PR ,et al. High dose of 131I therapy for the treatment of hyperthyroidism caused by Graves′ disease [J]. J Clin Endocrinol Metab, 2002,873):1073-1077. DOI: 10.1210/jcem.87.3.8333 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Rivkees SA , Cornelius EA . Influence of iodine-131 dose on the outcome of hyperthyroidism in children[J]. Pediatrics, 2003,1114Pt 1):745-749. DOI: 10.1542/peds.111.4.745 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Dobyns BM , Sheline GE , Workman JB ,et al. Malignant and benign neoplasms of the thyroid in patients treated for hyperthyroidism: a report of the cooperative thyrotoxicosis therapy follow-up study[J]. J Clin Endocrinol Metab, 1974,386):976-998. DOI: 10.1210/jcem-38-6-976 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Nebesio TD , Siddiqui AR , Pescovitz OH ,et al. Time course to hypothyroidism after fixed-dose radioablation therapy of Graves′ disease in children[J]. J Pediatr, 2002,1411):99-103. DOI: 10.1067/mpd.2002.125494 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Read CH Jr , Tansey MJ , Menda Y ,et al. A 36-year retrospective analysis of the efficacy and safety of radioactive iodine in treating young Graves′ patients[J]. J Clin Endocrinol Metab, 2004,899):4229-4233. DOI: 10.1210/jc.2003-031223 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Davis S , Kopecky KJ , Hamilton TE ,et al. Thyroid neoplasia, autoimmune thyroiditis, and hypothyroidism in persons exposed to iodine 131 from the hanford nuclear site[J]. JAMA, 2004,29221):2600-2613. DOI: 10.1001/jama.292.21.2600 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Laurberg P , Berman DC , Bülow Pedersen I ,et al. Incidence and clinical presentation of moderate to severe Graves′ orbitopathy in a Danish population before and after iodine fortification of salt[J]. J Clin Endocrinol Metab, 2012,977):2325-2332. DOI: 10.1210/jc.2012-1275 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Bartalena L , Baldeschi L , Dickinson AJ ,et al. Consensus statement of the European group on Graves′ orbitopathy (EUGOGO) on management of Graves′ orbitopathy[J]. Thyroid, 2008,183):333-346. DOI: 10.1089/thy.2007.0315 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Sridama V , DeGroot LJ . Treatment of Graves′ disease and the course of ophthalmopathy[J]. Am J Med, 1989,871):70-73. DOI: 10.1016/S0002-9343(89)80485-1 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Lee YY , Tam KW , Lin YM ,et al. Recombinant human thyrotropin before 131I therapy in patients with nodular goitre: a meta-analysis of randomized controlled trials [J]. Clin Endocrinol (Oxf), 2015,835):702-710. DOI: 10.1111/cen.12654 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Magner J . Problems associated with the use of thyrogen in patients with a thyroid gland[J]. N Engl J Med, 2008,35916):1738-1739. DOI: 10.1056/NEJMc0807896 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Ferrari C , Reschini E , Paracchi A . Treatment of the autonomous thyroid nodule: a review[J]. Eur J Endocrinol, 1996,1354):383-390. DOI: 10.1530/eje.0.1350383 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
Ceccarelli C , Bencivelli W , Vitti P ,et al. Outcome of radioiodine-131 therapy in hyperfunctioning thyroid nodules: a 20 years′ retrospective study[J]. Clin Endocrinol (Oxf), 2005,623):331-335. DOI: 10.1111/j.1365-2265.2005.02218.x .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Meller J , Siefker U , Hamann A ,et al. Incidence of radioiodine induced Graves′ disease in patients with multinodular toxic goiter[J]. Exp Clin Endocrinol Diabetes, 2006,1145):235-239. DOI: 10.1055/s-2006-924239 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
中华人民共和国国家卫生和计划生育委员会. WS 533-2017中华人民共和国卫生行业标准:临床核医学患者防护要求[S]. 北京中国标准出版社 2017.
National Health and Family Planning Commission of the People′s Republic of China. WS 533-2017 Health industry standards of the People′s Republic of China: requirements for patient radiation protection in clinical nuclear medicine[S]. Beijing:China Standards Press, 2017.
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蒋宁一,Email: mocdef.mabot.pivjiygnin
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公益性卫生行业科研专项 (200802028)
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