锂与甲状腺。

Lithium and thyroid.

机构信息

Centre for Endocrine and Diabetes Sciences, Cardiff University School of Medicine, University Hospital of Wales, Cardiff CF14 4 XN, Wales, UK.

出版信息

Best Pract Res Clin Endocrinol Metab. 2009 Dec;23(6):723-33. doi: 10.1016/j.beem.2009.06.002.

DOI:10.1016/j.beem.2009.06.002

PMID:19942149

Abstract

One in 200 people receive lithium for treatment of bipolar disorder. The common clinical side effects of the drug are goitre in up to 40% and hypothyroidism in about 20%. Lithium increases thyroid autoimmunity if present before therapy. Treatment with levothyroxine is effective and lithium therapy should not be stopped. Lithium may cause hyperthyroidism due to thyroiditis or rarely Graves' disease. As lithium inhibits thyroid hormone release from the thyroid gland it can be used as an adjunct therapy in the management of severe hyperthyroidism. It also increases thyroidal radioiodine retention and may be effective in reducing administered activity in hyperthyroidism. There is no clinical benefit of lithium therapy in thyroid cancer. More research is required on the cellular proliferative effects of lithium as well as its impact on the immune system.

摘要

每 200 个人中就有 1 个人接受锂治疗双相情感障碍。该药物的常见临床副作用是甲状腺肿，高达 40%，甲状腺功能减退症约 20%。如果锂治疗前存在甲状腺自身免疫，锂会增加甲状腺自身免疫。左甲状腺素治疗有效，锂治疗不应停止。锂可能由于甲状腺炎或罕见的格雷夫斯病引起甲状腺功能亢进症。由于锂抑制甲状腺从甲状腺释放甲状腺激素，因此它可作为严重甲状腺功能亢进症管理中的辅助治疗。它还增加甲状腺放射性碘保留，并且在减少甲状腺功能亢进症中使用的活性方面可能有效。锂治疗对甲状腺癌没有临床益处。需要对锂的细胞增殖作用及其对免疫系统的影响进行更多研究。