南方医科大学：《内科学》课程教学课件（讲稿）第七篇 内分泌和代谢性疾病 第十章 甲状腺功能亢进 Hyperthyroidism（病因和诊断）

甲状腺机能亢进症 Thyroid Hyperthyroidism Second clinical medical college, Southern Medical University 南方医科大学第二临床医学院 Department of Endocrinology and Metabolism, Yang Li 内分泌代谢科杨力

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Thyroid Gland甲状腺 The word "Thyroid"comes from the Greek "Thyreos" Thyreos=Shield盾牌

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Thyroid Gland甲状腺 Cricoid cartilage 环状软骨 isthmus lobes Trachea 气管 sternal notch 胸骨切迹

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What Does Your Thyroid Gland do for You? Factory to produce TH甲状腺激素工厂 First Step Follicle(滤泡) the Functional Second Step Units. Two kinds of thyroid hormone Qar iodine atom lodine 碘离子 Thyroxine(T4) Triiodothyronine(T3 Third Step 四碘甲状腺原氨酸 三碘甲状腺原氨酸

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The Negative feedback of Thyroid Hormones 难点★★★ thyrotropin-releasing hormone (促甲状腺释放激素TRH) hypothalamus 下丘脑 thyroid-stimulating hormone (促甲状腺激素TSH) Pituitary 垂体 Thyroid gland Thyroid hormone (甲状腺激素T3&T4)

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The Function of Thyroid Hormone 新陈代谢的“主控制器” 。 Brain maturation(大脑成熟) 。 Bone growth(骨生长) ·Body temperature(体温) 10 BMR ·Basal Metabolic(基础代谢) ·Heart Beat(心率)

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When the Thyroid goes Wrong Thyroid ·Too Much Thyroid Hormone Too Little Thyroid Hormone ·Metabolism Speeds Up Metabolism Slows Down

When the Thyroid goes Wrong • Too Much Thyroid Hormone • Metabolism Speeds Up • Too Little Thyroid Hormone • Metabolism Slows Down

Thyrotoxicosis(甲状腺毒症)

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·Thyrotoxicosis(甲状腺毒症)：excess serum levels of T.4and T3 from any source血中过量甲状腺激素一组l临床综合征 。 甲状腺功能亢进型Hyperthyroidism ·非甲状腺功能亢进型（炎症、外源型）

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Causes of Thyrotoxicosis 一、 非甲状腺功能亢进型(Thyrotoxicosis without hyperthyroidism) 1.亚急性甲状腺炎(subacute thyroiditis) 2.无症状性甲状腺炎(silent thyroiditis) 3.桥本甲状腺炎(hashimoto thyroiditis) 4.产后甲状腺炎(postpartum thyroiditis) 5. 外源甲状腺激素(exogenous hyperthyroidism) b.异位甲状腺激素(aberrant thyroid)

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