从流行病学角度看老年人甲状腺疾病的合理管理

Optimal management of thyroid diseases in the elderly from epidemiological perspectives

摘要:

甲状腺疾病是老年人最为常见的疾病之一。基于人群和临床的流行病学研究表明，老年人群的甲状腺疾病患病谱不同于普通成人，呈现独特的“高低”现象：临床甲减和亚临床甲减、甲状腺结节患病率更高，甲状腺癌患病率相对较低，但甲状腺恶性肿瘤的复发率和相关死亡率均更高。女性、碘缺乏、甲状腺相关抗体阳性、糖脂代谢紊乱会增加甲状腺疾病的患病风险。因此，了解目前老年人群甲状腺疾病的流行病学特点，识别相关危险因素，有助于促进老年甲状腺疾病规范化管理。

Abstract:

Thyroid disease is one of the most common diseases in the elderly. Population-and clinical epidemiology-based studies have shown that the prevalence of thyroid diseases in the elderly is different from general adults, showing a unique "high and low" phenomenon: the prevalence of clinical hypothyroidism and subclinical hypothyroidism and thyroid nodules is higher; the prevalence of thyroid cancer is relatively low, whereas the recurrence rate and mortality are higher. Female, iodine deficiency, positive thyroid autoantibodies, disturbance of glucose and lipid metabolism increase the risk of thyroid diseases. Therefore, understanding the epidemiological characteristics of thyroid diseases in the elderly and identifying relevant risk factors will help promote the standardized management of thyroid diseases in the older population.