Franklyn J A, Sheppard M C
Department of Medicine, University of Birmingham, Queen Elizabeth Hospital, Birmingham, England.
Trends Endocrinol Metab. 1993 May-Jun;4(4):128-31. doi: 10.1016/1043-2760(93)90036-e.
Amiodarone is a potent and widely used antiarrhythmic drug that bears a structural resemblance to thyroid hormones. The high iodine content of the drug determines that amiodarone induces changes in circulating concentrations of thyroid hormones, largely through inhibition of conversion of thyroxine (T(4)) to tri-iodothyronine (T(3)). Amiodarone treatment typically results in a rise in serum T(4), often to above the normal range, associated with a fall in circulating T(3). These biochemical changes are found in subjects who remain clinically euthyroid. In addition to changes in circulating thyroid hormones found in euthyroid subjects, overt thyrotoxicosis and hypothyroidism may complicate amiodarone treatment. Amiodarone-induced thyrotoxicosis is more common in areas of iodine deficiency, whereas hypothyroidism is more common in iodine-rich parts of the world.
胺碘酮是一种强效且广泛使用的抗心律失常药物，其结构与甲状腺激素相似。该药物的高碘含量决定了胺碘酮会引起甲状腺激素循环浓度的变化，主要是通过抑制甲状腺素（T4）向三碘甲状腺原氨酸（T3）的转化。胺碘酮治疗通常会导致血清T4升高，常常高于正常范围，同时伴有循环T3下降。这些生化变化在临床上仍处于甲状腺功能正常的受试者中也能发现。除了甲状腺功能正常的受试者出现的循环甲状腺激素变化外，明显的甲状腺毒症和甲状腺功能减退也可能使胺碘酮治疗变得复杂。胺碘酮所致的甲状腺毒症在碘缺乏地区更为常见，而甲状腺功能减退在世界上碘丰富的地区更为常见。
