老年人甲状腺功能减退症的诊断和治疗：一个新的老年挑战。
Diagnosis and treatment of hypothyroidism in old people : A new old challenge.
机构信息
Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy.
出版信息
Wien Klin Wochenschr. 2020 Mar;132(5-6):161-167. doi: 10.1007/s00508-019-01579-8. Epub 2019 Nov 26.
PURPOSE
To review the diagnosis and the treatment of both subclinical and overt hypothyroidism in old people, which could represent a challenge for the clinicians.
METHODS
Narrative literature review. An extensive literature search was performed using the databases of Scopus, Medline through PubMed, and Google Scholar from January 1975 to May 2019. The search terms were "hypothyroidism," "older adults," "elderly," and "myxedema."
RESULTS
Hypothyroidism is more common among older subjects in comparison to the younger counterparts. The hypothalamic-pituitary-thyroid axis and its hormones undergo significant changes due to the physiological aging process. For a correct diagnosis of hypothyroidism in old people clinicians must take such age-related changes into account.
CONCLUSIONS
The administration of replacement therapy in older adults should consider frailty, polypharmacy and a high risk to develop overtreatment symptoms. On the other hand, older patients with untreated or undertreated hypothyroidism may develop a state of myxedema coma.
目的
回顾老年人亚临床和显性甲状腺功能减退症的诊断和治疗，这对临床医生来说是一个挑战。
方法
叙述性文献回顾。使用 Scopus、PubMed 中的 Medline 和 Google Scholar 数据库，从 1975 年 1 月至 2019 年 5 月进行了广泛的文献检索。检索词为“甲状腺功能减退症”、“老年人”、“老年人”和“黏液性水肿”。
结果
与年轻人相比，老年人甲状腺功能减退症更为常见。由于生理老化过程，下丘脑-垂体-甲状腺轴及其激素发生了显著变化。为了正确诊断老年人的甲状腺功能减退症，临床医生必须考虑到与年龄相关的变化。
结论
在老年患者中，应考虑到虚弱、多种药物治疗和发生过度治疗症状的高风险来进行替代治疗。另一方面，未经治疗或治疗不足的老年甲状腺功能减退症患者可能会发展为黏液性水肿昏迷。
Zotero 插件