无痛性甲状腺炎的真实患病率难以确定,且因地理位置、患者接受筛查的密切程度以及是否所有甲状腺毒症患者都接受了诊断性放射性核素影像学断评估而异。在一个患者系列中,高达 23% 的甲状腺毒症患者有无痛性甲状腺炎,[3]Nikolai TF, Brousseau J, Kettrick MA, et al. Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis). Arch Intern Med. 1980;140:478-482.http://www.ncbi.nlm.nih.gov/pubmed/6892676?tool=bestpractice.com但其他研究报告的比例低很多。[1]Woolf PD. Transient painless thyroiditis with hyperthyroidism: a variant of lymphocytic thyroiditis? Endocr Rev. 1980;1:411-420.http://www.ncbi.nlm.nih.gov/pubmed/7018893?tool=bestpractice.com[2]Samuels MH. Subacute, silent and postpartum thyroiditis. Med Clin North Am. 2012;96:223-233.http://www.ncbi.nlm.nih.gov/pubmed/22443972?tool=bestpractice.com根据甲状腺毒症患者中无痛性甲状腺炎的患病率 (23%) 和人群研究中甲状腺毒症发病率进行粗略估计的结果显示,无痛性甲状腺炎发病率约为 0.28 例每 1000 人-年。[6]Miller KK, Daniels GH. Association between lithium use and thyrotoxicosis caused by silent thyroiditis. Clin Endocrinol (Oxf). 2001;55:501-508.http://www.ncbi.nlm.nih.gov/pubmed/11678833?tool=bestpractice.com女性发病的可能性高2倍并且可以发生在所有年龄段,虽然平均发病年龄在30岁。[1]Woolf PD. Transient painless thyroiditis with hyperthyroidism: a variant of lymphocytic thyroiditis? Endocr Rev. 1980;1:411-420.http://www.ncbi.nlm.nih.gov/pubmed/7018893?tool=bestpractice.com[2]Samuels MH. Subacute, silent and postpartum thyroiditis. Med Clin North Am. 2012;96:223-233.http://www.ncbi.nlm.nih.gov/pubmed/22443972?tool=bestpractice.com在 7% 的妊娠(范围为 1% 至 17%)后可发生产后甲状腺炎,但只有三分之一的患者出现甲状腺毒症(一些人的甲状腺毒症期未被发现)。[4]Stagnaro-Green A. Clinical review 152: postpartum thyroiditis. J Clin Endocrinol Metab. 2002;87:4042-4047.http://press.endocrine.org/doi/full/10.1210/jc.2002-020524http://www.ncbi.nlm.nih.gov/pubmed/12213841?tool=bestpractice.com也有报道在自发流产或治疗性流产后出现。[14]Marqusee E, Hill JA, Mandel SJ. Thyroiditis after pregnancy loss. J Clin Endocrinol Metab. 1997;82:2455-2457.http://press.endocrine.org/doi/full/10.1210/jcem.82.8.4168http://www.ncbi.nlm.nih.gov/pubmed/9253317?tool=bestpractice.com甲状腺功能异常见于高达三分之一接受细胞因子或生物制剂治疗的患者,但只有 2% 到 3% 出现一过性的甲状腺毒症。[5]Carella C, Mazziotti G, Amato G, et al. Clinical review 169: interferon-a-related thyroid disease: pathophysiological, epidemiological, and clinical aspects. J Clin Endocrinol Metab. 2004;89:3656-3661.http://www.ncbi.nlm.nih.gov/pubmed/15292282?tool=bestpractice.com[7]Ahmadieh H, Salti I. Tyrosine kinase inhibitors induced thyroid dysfunction: a review of its incidence, pathophysiology, clinical relevance, and treatment. Biomed Res Int. 2013;2013:725410.https://www.hindawi.com/journals/bmri/2013/725410/http://www.ncbi.nlm.nih.gov/pubmed/24282820?tool=bestpractice.com[8]Torino F, Barnabei A, Paragliola R, et al. Thyroid dysfunction as an unintended side effect of anticancer drugs. Thyroid. 2013;23:1345-1366.http://www.ncbi.nlm.nih.gov/pubmed/23750887?tool=bestpractice.com与之相似,患者使用锂剂时甲状腺功能减退症的患病率也高,无痛性甲状腺炎的发生率为 1.3 例每 1000 患者-年,或约为一般人群的 5 倍。[6]Miller KK, Daniels GH. Association between lithium use and thyrotoxicosis caused by silent thyroiditis. Clin Endocrinol (Oxf). 2001;55:501-508.http://www.ncbi.nlm.nih.gov/pubmed/11678833?tool=bestpractice.com自身免疫性甲状腺炎在碘摄入过量的地理区域更为普遍。[15]Teng W, Shan Z, Teng X, et al. Effect of iodine intake on thyroid diseases in China. N Engl J Med. 2006;354:2783-2793.http://www.nejm.org/doi/full/10.1056/NEJMoa054022#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/16807415?tool=bestpractice.com