什么是亚急性甲状腺炎？

Thyroiditis refers to the inflammation of the thyroid. The thyroid is a gland in the front of the neck that releases a variety of hormones. These hormones help regulate metabolism, the process that converts food into energy. They also play a crucial role in your physical and emotional responses, such as fear, excitement, and pleasure.

甲状腺炎包括一组导致甲状腺发炎的疾病。大多数类型的甲状腺炎通常会导致甲状腺功能亢进或甲状腺功能减退症。Hyperthyroidismis a disorder in which the thyroid is overactive and produces too much hormones.Hypothyroidismis a condition in which the thyroid is underactive and doesn’t make enough hormones. Both of these conditions can cause weight changes, anxiety, and fatigue.

Subacute thyroiditis is a rare type of thyroiditis that causes pain and discomfort in the thyroid. People with this condition will also have symptoms of hyperthyroidism and later develop symptoms of hypothyroidism. While often temporary, subacute thyroiditis can cause permanent complications if left untreated.

与其他形式的甲状腺炎不同，亚急性甲状腺炎被认为与病毒感染有关。为了响应病毒，甲状腺肿胀会破坏激素的产生。这会引起炎症和多种症状。

Subacute thyroiditis is slightly more common in women aged 40 to 50 than it is in men of the same age. It generally occurs after an upper respiratory infection, such as thefluor themumps。

Unlike other forms of thyroiditis, subacute thyroiditis causes pain in the thyroid gland. In some cases, this pain might also spread to other parts of your neck, ears, or jaw. Your thyroid may be swollen and tender to the touch. TheAmerican Thyroid Association估计疼痛通常持续1到3个月。

亚急性甲状腺炎的其他症状包括：

  • 发烧
  • 疲劳
  • weakness
  • hoarseness
  • 吞咽困难

Hyperthyroidism symptoms

大多数人通常在亚急性甲状腺炎的最初阶段发展甲状腺功能亢进。疾病此阶段的症状可能包括：

  • irritability
  • anxiety
  • restlessness
  • trouble concentrating
  • diarrhea
  • sudden weight loss
  • 快速或不规则的心跳
  • 体温升高，通常导致出汗过多
  • 震颤

甲状腺功能减退症

As the disease progresses, hypothyroidism generally replaces hyperthyroidism in the second stage. The symptoms during the second stage may include:

  • 疲劳
  • hair loss
  • 冷不宽容
  • 便秘
  • 突然体重增加
  • 月经期
  • depression

亚急性甲状腺炎的第一阶段通常持续不到三个月。第二阶段可能会持续9到15个月。

亚急性甲状腺炎有四种不同的亚型：

亚急性肉芽肿甲状腺炎：This是亚急性甲状腺炎的最常见类型。这主要是由病毒感染引起的。

Postpartum thyroiditis:This occurs in women within one year after giving birth, and usually goes away within 18 months. Women who develop this form of thyroiditis are thought to have an underlying autoimmune disease that causes the inflammation. Symptoms occur in two phases, starting with hyperthyroid symptoms and moving to hypothyroid symptoms.

Subacute lymphocytic thyroiditis:This also occurs during the postpartum period. Hyperthyroid symptoms develop earlier (usually within three months after giving birth), and hypothyroid symptoms can last for several months after.

触诊甲状腺炎：This develops when thyroid follicles are damaged from mechanical manipulation such as repeated examination of the thyroid gland or surgery.

All of the subtypes of subacute thyroiditis follow a similar course of symptoms, with hyperthyroid developing first. The key differences are the causes.

您的医生会感觉到并检查您的脖子，以查看甲状腺是否肿大或发炎。他们还会询问您有关您的症状和最近的病史。如果您最近在上呼吸道中感染了病毒感染，您的医生将更有可能检查亚急性甲状腺炎。

Your doctor will order a blood test to confirm a subacute thyroiditis diagnosis. This test will check the levels of certain hormones in your blood. Specifically, the blood test will measure your thyroid hormone, or freeT4, and甲状腺刺激激素（TSH）级别。免费的T4和TSH级别是所谓的“内部反馈循环”的一部分。当一个级别高时，另一个级别很低，反之亦然。

血液检查的结果将根据疾病的阶段而有所不同。在初始阶段，您的免费T4级别将很高，而您的TSH级别将很低。在后期，您的TSH级别将很高，而您的T4水平将很低。两种激素的异常水平表明亚急性甲状腺炎。

If you’re diagnosed with subacute thyroiditis, your doctor will give you medications to help reduce the pain and control inflammation. In some cases, this is the only treatment required for subacute thyroiditis. Possible medications include:

  • 非处方非甾体类抗炎药（NSAIDS）。Medications like aspirin and ibuprofen work by reducing inflammation. As a result, you will experience less pain. Acetaminophen (Tylenol) is not as effective because it doesn’t reduce the inflammation thyroiditis causes.
  • 皮质类固醇。糖皮质激素使用时非甾体抗炎药是不够的to reduce swelling. Prednisone is a common corticosteroid used to treat subacute thyroiditis. Your doctor may prescribe 15 to 30 milligrams per day to start, and then slowly decrease the dosage over three to four weeks.
  • Beta-blockers.Your doctor may prescribe beta-blockers if hyperthyroidism is present in the early stages. These medications lower blood pressure and pulse rate to relieve certain symptoms, including anxiety and an irregular heartbeat.

甲状腺功能亢进症的治疗在疾病的开始很重要。但是，一旦您的病情进入第二阶段，它将无济于事。在疾病的后期，您将发展甲状腺功能减退症。您可能需要服用诸如左甲状腺素之类的激素来代替您的身体没有产生的激素。

亚急性甲状腺炎的治疗通常是暂时的。您的医生最终将为您提供任何用于治疗这种情况的药物。

There are no clear preventive measures for subacute thyroiditis because the precise cause is unknown. Recurrence is not common.

In many cases, subacute thyroiditis resolves on its own without warning. The overall prognosis depends on the extent of damage in the thyroid gland. If a lot of damage is done, you might experience permanent thyroid issues and need ongoing medical attention.

The symptoms of subacute thyroiditis usually go away within 12 to 18 months. In some cases, however, hypothyroidism may end up being permanent.The American Thyroid Association据估计，大约5％的亚急性甲状腺炎患者会出现永久性甲状腺功能减退症。永久健康问题极为罕见。

Call your doctor if you suspect you have subacute thyroiditis. Early diagnosis and treatment can help prevent developing permanent hypothyroidism.