九、预后

需告知无痛性甲状腺炎患者今后有进展至慢性自身免疫甲状腺炎的风险。无痛性甲状腺炎发生永久性甲减者少于5%。持续的甲状腺自身抗体阳性预示永久甲减的发生。而大约50%甲状腺自身抗体进行性下降至消失的患者中，甲状腺功能恢复并且稳定在正常水平。10%～15%的无痛性甲状腺炎患者可能复发，但是往往间隔几年，复发的患者发生永久性甲减的风险增加，10年后约20%的患者为持续性甲减。这些患者在几年中对碘诱导的甲减易感。因此需在临床缓解后数年内定期监测甲状腺功能。无痛性甲状腺炎患者出现永久性甲减的特征包括高滴度的甲状腺自身抗体，缺少甲状腺毒症期，初始甲减状态严重、持续的甲状腺肿和超声中低回声区扩大。

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