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[胺碘酮与甲状腺功能障碍]

[Amiodarone and thyroid dysfunction].

作者信息

Rizzo Leonardo F L, Bruno Oscar D

机构信息

Estudios Metabólicos y Endocrinos, Buenos Aires.

出版信息

Medicina (B Aires). 2012;72(1):63-74.

Abstract

Amiodarone is a structural analogue of thyroid hormone, and some of its anti-arrhythmic actions and toxicity are attributable to its interaction with nuclear receptors of thyroid hormones. Being highly lipophilic, amiodarone is concentrated in many tissues and is eliminated, consequently, very slowly. It is preferably employed to manage life-threatening arrhythmias, including ventricular fibrillation and unstable ventricular tachycardia. Other indications include atrial fibrillation and flutter, severe congestive heart failure, prevention of atrial fibrillation recurrence, and even in emergency medical situations to prevent sudden cardiac death. The aim of this review is to provide an updated approach on amiodarone and its influence on thyroid physiology and to discuss and analyze in depth its potential and not infrequent thyroidal adverse effects such as hypothyroidism and thyrotoxicosis.

摘要

胺碘酮是甲状腺激素的结构类似物,其一些抗心律失常作用和毒性归因于它与甲状腺激素核受体的相互作用。由于胺碘酮具有高度脂溶性,它会在许多组织中蓄积,因此消除非常缓慢。它首选用于治疗危及生命的心律失常,包括心室颤动和不稳定的室性心动过速。其他适应证包括心房颤动和扑动、严重充血性心力衰竭、预防心房颤动复发,甚至在紧急医疗情况下预防心源性猝死。本综述的目的是提供关于胺碘酮及其对甲状腺生理影响的最新研究方法,并深入讨论和分析其潜在的且并不罕见的甲状腺不良反应,如甲状腺功能减退和甲状腺毒症。

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