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갑상선질환에 대한 임상적 관찰

Other Titles
 Clinical studies on thyroid disease 
Authors
 최성규 
Issue Date
1984
Description
의학과/석사
Abstract
[한글]

갑상선질환은 갑상선종과 홀몬분비의 이상으로 구분된다. 갑상선질환의 증상으로는 정부와 상부중격동의 국소적 압박증상, 홀몬생성의 이상으로 인한 갑상선기능저하증 혹은기능항진증이 나타나며 때로 악성종양으로도 진전된다. 갑상선질환의 진단으로 과거에는병력, 증세, 이학적소견과 경부X-선촬영 등을 시행하였고 1960년대 초부터 동위원소시설이 국내에 도입되면셔 갑상선질환에 대한 임상적보고예가 많아졌으나 주로 외과적인 표본에 치중하고 갑상선질환전반에 대한 임상적 검색은 적었다.

저자는 1968년 11월부터 1984년 3월까지 서울고려병원에서 입원한 각종 갑상선질환환자 532예를 대상으로 임상적 고찰을 하여 다음과 같은 결론을 얻었다.

1. 전 입원환자에 대한 갑상선질환환자의 비율은 0.45%였다.

2. 갑상선질환의 병류별 분포는 Grave씨병 (35.3%), 갑상선종양(28%), 원발성 갑상선기능저하증 (10.1%), nontoxic diffuse goiter (9%), adenomatous goiter(3.2%)의 순이었다.

3. 년령별로 21∼40세가 50%로 가장 빈도가 높았고, 남녀비 1:4.8이었다.

4. 갑상선종양 149예중 양성종양은 89예로 그중 follicular adenoma가 93.2%, 악성종양은 60예로 그중 papillary carcinoma가 63.3%이고 follicular carcinoma가 15.0%였다.

5. Grave씨병은 혈청 73,T^^3, T^4, FT^^4 와 I**131 섭취율이 진단적 정확성이 상호유사하였고 원발성 갑상선기능저하증은 혈청 TSH 다음이 T^^3, T^^4, FT^^4, BMR, 혈청 choiesterol의 순으로 확진율이 높았다.

6. 갑상선자가항체는 Hashimoto씨병, 원발성 갑상선기능저하증 및 Grave씨병에서 유의한 양성반응을 보였고 특히 Hashimoto 씨병에서의 McAb 및 TGAb치는 유의한 높은 고역가를 나타냈다.

7. Grave씨병에서 TRH반응은 음성임에 비해 원발성 갑상선기능저하증은 1예를 제외한전래에서 현저한 증가반응을 나타냈고 nontoxic diffuse goiter와 nontoxic nodular goiter 에서는 정상대조군과 유사한 TRH반응을 보였다.

8. 갑상선기능저하증에서의 혈청 CPK, GOT 및 LDH치는 의의있계 증가하였고 갑상선홀몬요법 1개월후 혈청효소치들은 혈청TSH에 선행하여 거의 정상화하였으나 치료전 혈청CPK치 300Iu/ml이상 및 혈청LDH치 700u이상인 경우에는 정상화하는데 1개월이상 소요하였다.

[영문]

Clinical studies were carried out on 532 cases with thyroid disease admitted during last 15 years (1968-1984) in Korea General Hospitals Seoul, Korea.

The results were as follows.

1. Prevalence of thyroid diseases was estimated as 0.45% of all the inpatient.

2. It was found that the most common thyroid cases was Graves 1disease representing as high as 35.3%, thyroid tumor as 28% primary hypothyrodism as 10.1% and nontoxic diffuse 9%.

3. The ages ranged from 7 to 80 years, the peak incidence(50%) were noted in the range of 21 to 40 years. Sex ratio revealed preponderance of female with ratio of 1:4.8

4. The reliable function test of Graves' disease was the measurements of T^^3, T^^4, free T^^4 in serum and radioactive iodine uptake for 24 hrs. Radioimmunoassay of serum TSH was considered the most accurate test in patients with primary

hypothyrodism.

5. Among 149 cases with thyroid tumors removed surgically, 89 Patients had begign tumor and 60 patients had malignant tumor. The most common type of benign tumor was follicular adenomar adenoma(93.2%) and malignancy was adenocardinoma (63.3%).

6. The positive rate of thyroid autoantibodies were higher in patients with Hashimoto's diseased Graves' disease and primary hypothyroidism 1 and among them patients with Hashimotol' disease showed the extremely high positive rate.

7. Graves' disease did not respond to TRH at all, the TSH response was exaggerated in primary hypothyrodism. But the response in nontoxic diffuse goiter and nontoxic nodular goiter patient was similar to normal control.

8. The level of serum CPK, GOT and LDH were significantly increased in hypothyroidism. The increased serum enzymes level in most patients had been lowered nearly to normal by oral hormonal replacement for one month except a few patients with extremely high level of LDH and CPK. The normalization of muscle enzymes often proceedes the correction of elevation in TSH
Full Text
https://ymlib.yonsei.ac.kr/catalog/search/book-detail/?cid=CAT000000044596
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1. College of Medicine (의과대학) > Others (기타) > 2. Thesis
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/126788
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