del Cerro Marín M, Fernández Ruiz A, García-Guereta L, Benito Bartolomé F, Burgueros M, Ares Segura S, Moreno F, Gracia Bouthelier R
Servicios de Cardiología Pediátrica. Hospital Infantil La Paz. Madrid.
Rev Esp Cardiol. 2000 Apr;53(4):517-24.
Iodinated contrast agents can block thyroid hormone synthesis. The aims of this study were: 1st) to study the incidence of thyroid function disturbances in children with congenital heart disease after cardiac catheterization, 2nd) to analyze the predisposing factors that may lead to the development of hypothyroidism after angiography, and 3rd) to determine the duration of these hypothyroidism states.
From february 1993 to April 1997 thyrotropine (TSH) and free thyroxine (FT4) serum values were analyzed before cardiac catheterization and in the two following weeks, in 99 children under three years of age, with congenital cardiac disease. Those patients who showed any postangiography increase in TSH were further evaluated by weekly measures of serum thyroid hormones and TSH until normal values were obtained or until the initiation of hormonal replacement therapy. The patients' data (age, previous exposure to contrast agents, cardiac disease, associated extracardiac malformations, renal failure, severity of illness, treatment) and the catheterism data (the dose and type of contrast and the fluoroscopy time) were included in the univariant analysis.
10 mUI/ml), that persisted beyond three weeks in six cases. The occurrence of multiple malformation syndromes was the most clearly associated risk factor (p < 0,01) not only in the development of postangiography hypothyroidism but also in longer hormonal dysfunction.
Thyroid function should be tested in every patient with multiple malformation syndrome that undergo angiocardiography with iodinated contrast agents.
碘化造影剂可阻断甲状腺激素合成。本研究的目的是：第一，研究先天性心脏病患儿心脏导管插入术后甲状腺功能紊乱的发生率；第二，分析血管造影术后可能导致甲状腺功能减退的诱发因素；第三，确定这些甲状腺功能减退状态的持续时间。
1993年2月至1997年4月，对99例3岁以下先天性心脏病患儿在心脏导管插入术前及术后两周测定血清促甲状腺激素（TSH）和游离甲状腺素（FT4）值。对血管造影术后TSH升高的患者，每周测定血清甲状腺激素和TSH，直至获得正常数值或开始激素替代治疗。单因素分析纳入患者数据（年龄、既往接触造影剂情况心脏病、心脏外合并畸形、肾衰竭、疾病严重程度、治疗情况）和导管插入术数据（造影剂剂量和类型、透视时间）。
……（此处原文似乎不完整）10 mUI/ml），6例持续超过3周。多种畸形综合征的出现是最明显的相关危险因素（p<0.01），不仅与血管造影术后甲状腺功能减退的发生有关，也与较长时间的激素功能障碍有关。
对每例接受碘化造影剂心血管造影的多种畸形综合征患者均应检测甲状腺功能。
