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目的 探讨儿童慢性淋巴细胞性甲状腺炎的临床表现特点、诊断方法及预后。方法 对76例慢性淋巴细胞性甲状腺炎患儿临床资料进行回顾性分析。结果 76例慢性淋巴细胞性甲状腺炎患儿,女性占81.59％,年龄为(10.52±3.12)岁,病程为(7.63±8.15)个月;全部病例均有甲状腺弥漫性肿大。初诊时临床表现为甲状腺功能亢进10例、甲状腺功能减低14例、无症状52例;初诊时临床诊断准确率为78.94％(60/76),甲状腺针吸细胞学检查(FNAB)诊断准确率为98.68％(75/76)。随访2个月至4.5年,26例表现为甲状腺功能减低,32例甲状腺肿大消失,28例抗体降至正常;13例痊愈,痊愈病例中12例FNAB为淋巴型。结论 儿童慢性淋巴细胞性甲状腺炎临床表现不典型,易误诊;FNAB诊断准确率高,并可早期诊断;FNAB结合甲状腺自身抗体检查可作为儿童慢性淋巴细胞性甲状腺炎较可靠诊断手段;儿童慢性淋巴细胞性甲状腺炎近期预后良好,预后可能与细胞学类型相关。
Objective To investigate the clinical features, diagnosis and prognosis of childhood chronic lymphocytic thyroiditis. Methods The clinical data of 76 children with chronic lymphocytic thyroiditis were retrospectively analyzed. Results 76 cases of children with chronic lymphocytic thyroiditis, female accounting for 81.59%, age (10.52 ± 3.12) years old, duration of (7.63 ± 8.15) months; all cases have diffuse thyroid enlargement. The clinical manifestations at first visit were hyperthyroidism in 10 cases, hypothyroidism in 14 cases and asymptomatic in 52 cases. The accuracy of clinical diagnosis at initial diagnosis was 78.94% (60/76). The diagnostic accuracy of thyroid needle aspiration cytology (FNAB) was 98.68% (75/76). Followed up for 2 months to 4.5 years, 26 cases showed hypothyroidism, 32 cases of goiter disappeared, 28 cases of antibody reduced to normal; 13 cases cured, cured cases of 12 cases of FNAB lymphoid. Conclusion The clinical manifestations of children with chronic lymphocytic thyroiditis are not typical, easily misdiagnosed; FNAB diagnostic accuracy rate, and early diagnosis; FNAB combined with thyroid autoantibodies can be used as a more reliable diagnosis of childhood chronic lymphocytic thyroiditis; children with chronic lymphoid Recent prognosis of cellular thyroiditis is good, the prognosis may be related to cytological types.