Problem description:
What is the harm of antibody A?
Analysis:
Instructions for patients with hyperthyroidism
CCTV International February 2004 18 16:08
1, Professor Yang Jinkui's doctoral supervisor was introduced to the Endocrinology Department of Tongren Hospital in 2002, and was hired as the chief physician, department director and chief expert. Participate in the national ninth five-year plan key projects and complete the national new drug project. The recent research direction is comprehensive treatment of hyperthyroidism exophthalmos and early prevention and treatment of diabetic retinopathy. (Left)
2. Professor Ji Linong's doctoral supervisor, Director of Endocrinology Department of Peking University People's Hospital, Member of the Standing Committee of Diabetes Society of Chinese Medical Association, Editorial Board of Endocrinology Society of Chinese Medical Association published more than 50 papers in recent years, and participated in the compilation of medical monographs 1 1. (right)
Moderator: Hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to talk about hyperthyroidism.
Reporter: Do you know hyperthyroidism?
Masses: It seems to be thick neck disease.
Man: It's the kind of disease that people can lose weight after eating.
Crowd: It's easy to jump out. There is also eating too much, drinking too much and urinating too much. There is also fatigue.
People: I don't know what hyperthyroidism is.
People: It's hyperthyroidism! It seems to be iodine deficiency. Eating kelp seems to prevent it, so eat iodized salt.
Moderator: Which of these statements is correct?
Yang Jinkui: Many of these people's views are very reasonable, but there are also many misunderstandings. For example, iodine deficiency will not lead to hyperthyroidism, but it will lead to endemic goiter. There are many reasons for the thick neck. Of course, the neck of hyperthyroidism patients will be thicker, but endemic goiter or some tumors will cause a thick neck, so a thick neck does not mean that it must be hyperthyroidism.
Ji Linong: Hyperthyroidism patients are mainly characterized by overeating and emaciation, and drinking too much and urinating too much is not obvious. Drinking more and eating more is also a typical symptom of diabetes.
Yang Jinkui: Exophthalmos is a typical clinical manifestation of hyperthyroidism patients. Of course, other diseases may also cause exophthalmos. In addition, patients with hyperthyroidism do not mean that exophthalmos is very obvious. About 50% patients with hyperthyroidism will have exophthalmos, but this exophthalmos can be divided into benign exophthalmos and malignant exophthalmos. Benign exophthalmos is generally a feeling of being angry, and the degree of exophthalmos is not obvious. As for the problem of three more and one less, in fact, many neurosis patients will have similar problems, such as bad temper, which is an atypical symptom.
Moderator: What are the typical symptoms?
Yang Jinkui: This is an obvious outbreak, but most of it is not.
Ji Linong: Many cases of thyroid exophthalmos are characterized by intense eyes, which don't seem to blink very much and seem to be very excited.
Yang Jinkui: In fact, a major feature of hyperthyroidism is that the symptoms are atypical.
Host: I'm watching a movie:
Reporter: We met such a patient in the clinic of Beijing Tongren Hospital. Fan Xiumin, 53, lives in the suburbs of Beijing. He usually feels in good health and often does some manual work, and there is nothing wrong with him. But last June, I suddenly felt my eyes swollen.
Patient: I just suddenly feel that my eyes are awkward, I can't open and swollen, so I often go to the ophthalmology department, but my eyes are getting more and more swollen, so I have to sleep half-closed. After many tossing and turning, I finally found out that it was caused by hyperthyroidism. Then I was admitted to Tongren Hospital.
Yang Jinkui: This patient took many detours in the process of seeing a doctor. I happened to see this patient and found that her symptoms should be hyperthyroidism. She was shivering, fidgeting and sweating. She was prescribed hyperthyroidism medicine without waiting for the examination. The course of hyperthyroidism is generally long, at least one and a half years. Generally, hyperthyroidism symptoms can be well controlled after 1-2 months of drug treatment, but the ocular symptoms last for a long time, usually about three years.
Ji Linong: Many patients with hyperthyroidism seen in our endocrinology clinic are transferred from ophthalmology, gastroenterology and cardiology. Some patients, especially the elderly, have very atypical symptoms. For example, some elderly people go to the gastroenterology department because of indigestion or anorexia, and it is discovered that they are hyperthyroidism after excluding gastrointestinal diseases. Some elderly people came to see heart disease because of atrial fibrillation, and then checked thyroid hormones and found that it was hyperthyroidism.
Moderator: What kind of serious consequences will hyperthyroidism bring if patients delay treatment for a long time?
Yang Jinkui: I mentioned a lot of atypical symptoms just now. Some symptoms were even found in a mental hospital or psychiatric department or because there was no menstruation. Of course, the most terrible thing is that the long-term lack of correct treatment has led to some serious consequences and even life-threatening. Here is a painful example. Women are laid-off workers. She had serious side effects after taking the medicine orally, and her liver function was seriously damaged. After checking the transaminase 1000, doctors dare not take medicine, and small hospitals do not have the treatment conditions. About a year or two later, severe heart failure appeared. After coming to our hospital, the patient was panting when sitting. After treatment, the patient can go downstairs. At this time, we mobilized her to do isotope therapy, which was the only way out, but the family members did not agree. Two months later, the symptoms worsened. By this time, it was too late for isotope therapy, and the patient died on the third day.
Moderator: Let's listen to another interview:
Mass: Hyperthyroidism seems to be iodine deficiency. There is a saying that iodine, methyl iodide and iodine are stupid, that is to say, the first generation of iodine deficiency is hyperthyroidism, the second generation of iodine deficiency children are stupid, and the third generation is cut off, that is, there are no children.
Compere: Is it true?
Ji Linong: This is a misunderstanding. In fact, goiter patients in iodine-deficient areas are not hyperthyroidism but goiter, because it is endemic for a long time. The first generation of children born with iodine deficiency will get cretinism, which is a small dementia child. Because the development of the central nervous system has been seriously damaged, such children will be infertile. After the country gradually paid attention to iodine supplementation in key areas, this situation has become less and less.
Moderator: Can hyperthyroidism be inherited?
Ji Linong: From the etiology, hyperthyroidism is a genetic disease, and many hyperthyroidism patients can often be seen in a family. The root cause of hyperthyroidism is autoimmune disease, so one family member has hyperthyroidism, and the other may be rheumatoid arthritis and other diseases.
Moderator: How is hyperthyroidism produced?
Yang Jinkui: As the picture shows, the thyroid gland is a very important organ of the human body. Its function mainly has several aspects. One is oxidation to produce heat, but the temperature is too high, which will inevitably lead to excessive heat production and a lot of sweating. Hyperthyroidism has influence on growth and development and nervous system. The other picture shows thyroid enlargement and thyroid function enhancement caused by autoimmune, which is caused by three factors: heredity, infection and mental factors.
Moderator: You should go to the endocrinology department to see hyperthyroidism, so are there many people with hyperthyroidism?
Ji Linong: There are still many people with hyperthyroidism. At present, the most patients in our endocrinology department are diabetic patients, followed by hyperthyroidism patients. Every day, about 20% of patients are patients with thyroid diseases, and most of them are patients with hyperthyroidism. Women belong to the susceptible population of autoimmune diseases. Generally speaking, the ratio of male to female suffering from hyperthyroidism is about 1: 4, with more females.
Moderator: Is hyperthyroidism difficult to diagnose?
Yang Jinkui: The diagnosis of hyperthyroidism is not difficult. The difficulty is that it is not easy to think that it may be hyperthyroidism. As a specialist, it is not difficult to judge. Of course, the final diagnosis needs some laboratory tests.
Ji Linong: The real diagnosis needs to check thyroid hormone, which is secreted by the thyroid gland and then enters the blood. It is necessary to draw venous blood and then detect the hormone level by special methods. It is necessary to emphasize a concept. The manifestations such as palpitation and overeating mentioned just now are all manifestations of elevated thyroid hormone, but there are many reasons that can cause the increase of thyroid hormone in the body, and hyperthyroidism is the most important one. Other conditions are thyroiditis. Therefore, if clinicians see typical thyroid symptoms, they must determine what causes them through laboratory tests. It must be clear before treatment, and sometimes even some auxiliary means, such as thyroid B-ultrasound, are needed.
Yang Jinkui: Let's talk about the treatment of thyroid. Generally speaking, hyperthyroidism is a controllable disease.
Treatment measures of hyperthyroidism
● Drug therapy
Thyroid hormone synthesis inhibition
● Isotope therapy
Knife-free operation
● Surgical treatment
Remove most of the thyroid gland.
Ji Linong: Drug therapy is the most widely used treatment method at present. The method is simple, easy for patients to accept and has good effect. The only drawback is that it takes a long time, and the dosage of drugs is different in different periods. Conventional treatment takes about a year and a half.
Yang Jinkui: Be careful not to stop taking drugs in advance at will, because the recurrence rate of stopping drugs in advance is high. Many studies show that the longer the drug is maintained (relatively speaking), the lower the recurrence rate. Generally speaking, the recurrence rate of oral drugs is still very high, probably above 60%.
Moderator: What kind of method is isotope therapy?
Ji Linong: Isotope therapy, also called internal surgery, can control symptoms well.
Moderator: Let's watch a video:
Reporter: Isotope therapy needs to come to the Department of Nuclear Medicine. This is the pharmacy room. The doors and walls are specially made. Patients will take a medicine called iodine 13 1 when they come. This medicine is a radionuclide. It is radioactive and looks like a capsule. After taking it, it will be about two hours before the next examination, that is, the detection of thyroid function. In addition, doctors need to do imaging examination similar to CT scan if they want to know the thyroid function image of patients. Iodine 13 1 is a radionuclide, is it harmful to health?
Yang Jinkui: Isotope therapy is a very safe method. After decades of clinical treatment, it has almost nothing to do with the occurrence of tumors. I did have this concern before. So now isotope therapy has a tendency to replace surgical treatment, and some doctors even advocate isotope therapy over drug treatment.
Moderator: Under what circumstances do you need isotope therapy?
Ji Linong: If the patient is not suitable for drug therapy and surgery, such as allergic to drugs and the body is not suitable for surgery, then isotope therapy can be performed. For example, some patients have atrial fibrillation, heart failure, periodic paralysis and so on because of hyperthyroidism. We emphasize radical cure, and isotope therapy is a good choice at this time. We hope that patients will never suffer from hyperthyroidism after receiving such treatment in an experienced hospital.
Moderator: Ms. Xu from Shantou, 30 years old, I am pregnant for 3 months. Because of hyperthyroidism, thyroid drugs have not been stopped. Does it affect the fetus?
Ji Linong: If pregnant women are found to have hyperthyroidism or elevated thyroid hormones during pregnancy, there are two possibilities. In the first three months of pregnancy, the thyroid gland tends to increase. This is a physiological reaction. It will rise slightly after the test and will recover after three months of pregnancy. Suggest observation. For patients with significantly elevated thyroid hormone, they can give birth safely under the condition of drug treatment.
Yang Jinkui: It is suggested that women with hyperthyroidism in pregnancy must be closely monitored, and PTU is the best choice for drugs. If the heart can't bear it, it may be necessary to terminate the pregnancy.