我的女友一年前查出亚急性甲状腺炎，医生给他开了一种叫强的松的药以及其他消炎药，但用药后还是时好时坏。最近重新抽血复查，发现甲状腺球蛋白抗体高达600，其他项目倒在正常范围内。请问甲状腺球蛋白抗体高可能是什么原因？是不是以前的治疗不起作用了？另外，日常有什么需要注意的吗？

    My girlfriend a year ago found to subacute thyroiditis,医生给他开了一种叫强的松的药As well as其他消炎药,But after medication or downs.Recent blood review again,Found that thyroglobulin antibody is as high as 600,Other projects fall within the normal range.Can you tell me high thyroglobulin antibody may be the reason why?是不是以前的治疗不since作用了?In addition,Everyday what need to be aware of?

    阿鹏

    Peng o

    解答：广东药学院附属第一医院内分泌科主任兼大内科主任周昭远副教授

    answer:The first hospital affiliated to guangdong college of pharmacy, director of endocrinology and big Zhou Zhaoyuan associate professor, director of the physician

    亚急性甲状腺炎病因不完全明确，一般认为是病毒感染后的自身免疫反应引起的甲状腺损伤，常在上呼吸道或消化道病毒感染后2~4周发生，表现为发热、颈痛和甲状腺肿大，肿块从一侧开始向另一侧蔓延，质地硬，有明显压痛（极少人可无疼痛和压痛），抽血检查发现甲状腺激素水平升高，但做甲状腺同位素扫描或吸碘率检查不显影或吸碘率低下，血沉检查很重要，是判断病情的重要指标之一。阿鹏先生的女友病情时好时坏，考虑与治疗不规则或疗程不够有关。

    Subacute thyroiditis etiology is not completely clear,一般认为是病毒感染后的自身免疫反应引since的甲状腺损伤,Often in the upper respiratory tract and the digestive tract 2 ~ 4 weeks after virus infection,Characterized by fever/Neck pain and goiter,Lump spreading from one side to another side,Quality of a material is hard,There are obvious tenderness(Few people can be free of pain and tenderness),Serologic examinations found that thyroid hormone levels,Isotopic scans or thyroid iodine absorption rate check but do not enhancement or iodine absorption rate is low,Check blood sedimentation is very important,Is one of the important indexes judging condition.Condition when Mr Peng's girlfriends,Consider associated with irregular treatment or treatment is not enough.

    一般而言，诊断亚急性甲状腺炎后可用强的松30~40mg/日，在发热消退，甲状腺肿痛缓解并且血沉正常后开始减量，每次减少5mg/日，5~7日减一次，如果病情反复则加回原来的剂量，总疗程1~3月，少数人要半年以上。其它非甾体类消炎止痛药也有效。就我个人经验，在病程早期加利巴韦林0.2，每日三次口服2周，有助于病情的控制并减少复发的机会。由于病人本身原因或减药过快，病情易反复，少数人可发展成桥本甲状腺炎，阿鹏先生的女友甲状腺球蛋白抗体高达600，考虑有桥本甲状腺炎的存在，得这个病要不要治疗，需要注意什么事项主要取决于病人本身。

    In general,After the diagnosis of subacute thyroiditis available prednisone 30 ~ 40 mg/day,The fever subsided,Goiter pain relief and reducing blood sedimentation after normal start,Reduce 5 mg/day at a time,5 to 7 days minus one times,If the disease is added back to the original dose over and over again,Total treatment course 1 ~ 3 months,A few people to more than six months.Other nonsteroidal anti-inflammatory analgesics are effective.On my personal experience,Early in the course of the California waring 0.2,Oral three times a day for 2 weeks,Help to control and minimize the chance of recurrence.Due to the patient itself or by drugs too quickly,Condition is again and again,A few people can be developed into the hashimoto thyroiditis,Thyroglobulin antibody is as high as 600 Mr Peng's girlfriends,Consider to have hashimoto thyroiditis,Have to want to treat this disease,Need to pay attention to what matters mainly depends on the patient itself.

    桥本甲状腺炎有三个转归，可以自己好，也可转化为甲亢，还可变成甲减，有甲亢或甲减需要针对性治疗，甲状腺功能正常而且甲状腺不是很大，没有压迫症状的可以不处理。由于甲状腺球蛋白抗体高，最好少吃含碘食物或药物，比如紫菜、海带等，抗心律失常药乙胺碘呋酮每片含碘75mg，是正常人日常碘需要量的500倍，若非必要，最好不用，非用不可则需监测甲状腺功能。如果甲状腺明显肿大有压迫症状，可以手术治疗，术后长期补充甲状腺激素治疗。（记者翁淑贤 通讯员庄文斌、吴亮军）

    Hashimoto thyroiditis has three outcomes,Can be good,Can also be converted to hyperthyroidism,Also can be turned into JiaJian,With hyperthyroidism or JiaJian need targeted treatment,Normal thyroid function and thyroid is not very big,No can not deal with compression symptoms.Due to their high thyroglobulin antibody,Had better eat less food or medicines containing iodine,Such as the laver/Seaweed, etc.,Anti-arrhythmic drug ethylamine iodic ketone every piece contains iodine 75 mg,Is 500 times of normal iodine daily requirements,If not necessary,Had better not,You need to monitor thyroid function.If the obviously enlarged thyroid symptoms of oppression,Can surgery,Postoperative thyroid hormone replacement therapy for a long time.(The reporter WengShuXian correspondent ZhuangWenBin/Wu Liangjun)