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目的探讨结节型桥本病诊断要点，减少误诊。方法回顾性分析２１例结节型桥本病的甲状腺功能改变、大体形态学改变、免疫学异常、病理改变及其诊断价值。结果甲状腺功能的改变：１３１Ⅰ吸收率异常、血清游离三碘甲状腺原氨酸（ＦＴ３）、血清游离甲状腺素（ＦＴ４）、血清总三碘甲状腺原氨酸（ＴＴ３）、血清总甲状腺素（ＴＴ４）、血清促甲状腺激素（ＴＳＨ）异常３８％（８／２１）；甲状腺腺叶肿大或全部呈结节状７６％（１６／２１）；甲状腺球蛋白抗体（ＴＧＡｂ）阳性（３／５），甲状腺微粒体抗体（ＴＭＡｂ）阳性（５／５）。结论甲状腺功能、形态和免疫学检查对结节型桥本病的诊断都有价值，其中免疫学检查是诊断本病的主要依据，必要时应先行术中冰冻检查
Objective To explore the diagnosis of nodular Hashimoto disease and reduce misdiagnosis. Methods Retrospective analysis of 21 cases of nodular Hashimoto’s disease thyroid function changes, gross morphological changes, immunological abnormalities, pathological changes and their diagnostic value. Results The changes of thyroid function were abnormal: Absorption rate of 131 Ⅰ, FT3, FT4, TT3, TT4, Thyroid gland lobes were enlarged or all of them were nodular 76% (16/21); Thyroglobulin antibody (TGAb) positive (3/5) Thymic microsomal antibodies (TMAb) were positive (5/5). Conclusion Thyroid function, morphology and immunological examination of nodular Hashimoto’s disease diagnosis are valuable, including immunological examination is the main basis for the diagnosis of the disease, if necessary, should be the first intraoperative frozen check