繼發性甲亢是什么意思
繼(ji)發性甲(jia)(jia)狀(zhuang)腺(xian)功(gong)能亢進癥,是指甲(jia)(jia)狀(zhuang)腺(xian)沒有發生(sheng)病變(bian),不(bu)是甲(jia)(jia)狀(zhuang)腺(xian)本身的疾病導致,而是由(you)于身體(ti)其他部(bu)位出現問(wen)題,使甲(jia)(jia)狀(zhuang)腺(xian)激素合成分泌(mi)增多,導致甲(jia)(jia)狀(zhuang)腺(xian)功(gong)能亢進,可見于妊娠、藥物、腫(zhong)瘤等因素。
繼發性甲亢是什么原因引起的
1、妊娠
妊娠期女性體內HCG含量較高,由于HCG與促甲狀腺激素有部分結構相似,可能會激動受體細胞促進甲狀腺激素分泌,從而導致繼發性甲狀腺功能亢進癥。
2、藥物
甲(jia)狀(zhuang)(zhuang)腺功(gong)能(neng)(neng)減退時,如果使用外源性甲(jia)狀(zhuang)(zhuang)腺激素(su)過多,導致體內甲(jia)狀(zhuang)(zhuang)腺激素(su)含量超過正常(chang)范圍,機體產(chan)生藥(yao)物性甲(jia)狀(zhuang)(zhuang)腺功(gong)能(neng)(neng)亢(kang)進癥(zheng)(zheng),也是繼發性甲(jia)狀(zhuang)(zhuang)腺功(gong)能(neng)(neng)亢(kang)進癥(zheng)(zheng)。這時,只要遵(zun)醫(yi)囑減少左甲(jia)狀(zhuang)(zhuang)腺素(su)鈉的用量,逐漸使體內甲(jia)狀(zhuang)(zhuang)腺激素(su)的水平恢復正常(chang),甲(jia)狀(zhuang)(zhuang)腺功(gong)能(neng)(neng)亢(kang)進癥(zheng)(zheng)的癥(zheng)(zheng)狀(zhuang)(zhuang)可逐漸消失。
3、腫瘤
常見于下丘腦垂(chui)體病變,如垂(chui)體促甲(jia)狀(zhuang)腺(xian)(xian)(xian)激(ji)(ji)素瘤,會使促甲(jia)狀(zhuang)腺(xian)(xian)(xian)激(ji)(ji)素分泌增多(duo),導(dao)致甲(jia)狀(zhuang)腺(xian)(xian)(xian)激(ji)(ji)素合成(cheng)增多(duo),出現(xian)繼(ji)發性甲(jia)狀(zhuang)腺(xian)(xian)(xian)功能(neng)亢(kang)進癥(zheng)。只(zhi)要將病變部位治(zhi)愈后,甲(jia)狀(zhuang)腺(xian)(xian)(xian)激(ji)(ji)素水平(ping)可(ke)以逐漸恢復正常。一些肺癌(ai)患(huan)者,可(ke)能(neng)出現(xian)甲(jia)狀(zhuang)腺(xian)(xian)(xian)激(ji)(ji)素的(de)分泌增多(duo),也(ye)屬于繼(ji)發性甲(jia)狀(zhuang)腺(xian)(xian)(xian)功能(neng)亢(kang)進癥(zheng)。當肺癌(ai)得到控制或者進行(xing)靶(ba)向治(zhi)療后,甲(jia)狀(zhuang)腺(xian)(xian)(xian)功能(neng)亢(kang)進癥(zheng)的(de)癥(zheng)狀(zhuang)可(ke)以逐漸緩解。
4、甲狀腺炎
部分甲狀(zhuang)腺(xian)炎可能(neng)(neng)導致T3、T4增多,出(chu)現繼發性甲狀(zhuang)腺(xian)功(gong)能(neng)(neng)亢進癥。當患者出(chu)現疾(ji)病后,要(yao)及時(shi)到醫院的內分泌科(ke)就診,以免延誤病情。
繼發性甲亢會突眼嗎
繼(ji)發(fa)性甲(jia)(jia)(jia)亢(kang)也是會(hui)有突眼(yan)(yan)(yan)(yan)(yan),因為繼(ji)發(fa)性甲(jia)(jia)(jia)亢(kang)患(huan)者也存在著交(jiao)感神(shen)(shen)經過度(du)興(xing)奮。交(jiao)感神(shen)(shen)經過度(du)興(xing)奮,就(jiu)會(hui)引起突眼(yan)(yan)(yan)(yan)(yan),這時候患(huan)者的(de)(de)眼(yan)(yan)(yan)(yan)(yan)睛(jing)突出,雙目(mu)炯炯有神(shen)(shen),瞬目(mu)減少,雙眼(yan)(yan)(yan)(yan)(yan)往(wang)上看(kan)的(de)(de)時候,額(e)紋不能抬(tai)起,這種(zhong)突眼(yan)(yan)(yan)(yan)(yan)稱為良(liang)性突眼(yan)(yan)(yan)(yan)(yan)。治療(liao)這種(zhong)突眼(yan)(yan)(yan)(yan)(yan)不需要特殊治療(liao)眼(yan)(yan)(yan)(yan)(yan)睛(jing),只(zhi)需要把甲(jia)(jia)(jia)亢(kang)控制好就(jiu)可以了(le),當甲(jia)(jia)(jia)狀(zhuang)腺功能逐(zhu)漸恢(hui)復正常,這種(zhong)良(liang)性突眼(yan)(yan)(yan)(yan)(yan)就(jiu)會(hui)逐(zhu)漸的(de)(de)恢(hui)復。
繼發性甲亢很(hen)少會(hui)出現惡性突(tu)(tu)眼,所以(yi)大部分的(de)繼發性甲亢患者(zhe)突(tu)(tu)眼都會(hui)得(de)到緩解。
繼發性甲亢和原發性甲亢區別
1、發病原理
原發(fa)性(xing)甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)功能亢(kang)進(jin)癥的發(fa)病(bing)部位為甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian),由于甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)病(bing)變造成(cheng)甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)(ji)素合成(cheng)與分泌增多,機體出現甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)功能亢(kang)進(jin)癥。而(er)繼發(fa)性(xing)甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)功能亢(kang)進(jin)癥是由于甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)以外(wai)的組(zu)織(zhi)(zhi)發(fa)生病(bing)變,刺激(ji)(ji)甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)組(zu)織(zhi)(zhi)增生,進(jin)而(er)產生過多的甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)(ji)素,發(fa)生甲(jia)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)功能亢(kang)進(jin)癥。
2、激素水平
促(cu)甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)與甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)之間為負反饋調節機制,對(dui)于(yu)原(yuan)發性甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)功能亢(kang)進癥(zheng)患者來(lai)說,甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)升高(gao),抑制促(cu)甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)的釋放和分泌,造成促(cu)甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)水(shui)(shui)平(ping)數值較低(di)。而繼發性甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)功能亢(kang)進癥(zheng)多數是由于(yu)下丘腦或(huo)垂體發生炎癥(zheng)、腫瘤等因素(su),引(yin)起促(cu)甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)水(shui)(shui)平(ping)明(ming)顯(xian)升高(gao),同時甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)水(shui)(shui)平(ping)合成、分泌增多,這時血液檢(jian)查促(cu)甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)、甲(jia)狀(zhuang)(zhuang)腺(xian)(xian)(xian)(xian)激(ji)素(su)的水(shui)(shui)平(ping)均在高(gao)水(shui)(shui)平(ping)狀(zhuang)(zhuang)態。
3、治療原則
原發性甲狀腺功能亢進癥主要針對原發病進行治療,繼發性甲狀腺功能亢進(jin)癥的(de)患者(zhe)一(yi)般針對下丘腦(nao)或垂體進(jin)行(xing)針對性的(de)治療。
4、臨床表現
原發(fa)性甲(jia)狀(zhuang)(zhuang)(zhuang)腺功能亢(kang)進癥的(de)患者(zhe)(zhe)通常發(fa)病較(jiao)迅速(su),且(qie)會(hui)出(chu)現(xian)突眼(yan)癥狀(zhuang)(zhuang)(zhuang),而繼發(fa)性甲(jia)狀(zhuang)(zhuang)(zhuang)腺功能亢(kang)進癥的(de)患者(zhe)(zhe)病程相對較(jiao)慢,且(qie)較(jiao)少(shao)出(chu)現(xian)突眼(yan)癥狀(zhuang)(zhuang)(zhuang)。但(dan)均可(ke)出(chu)現(xian)高(gao)(gao)代謝癥候(hou)群(qun),主要包括心慌、出(chu)汗、消瘦、食欲(yu)亢(kang)進等,由于(yu)神經肌(ji)肉的(de)興奮性增高(gao)(gao),患者(zhe)(zhe)還可(ke)出(chu)現(xian)手(shou)抖、雙手(shou)震顫(zhan)等癥狀(zhuang)(zhuang)(zhuang),應及時就(jiu)醫進行(xing)鑒別診(zhen)斷(duan)。