Aleksić Zeljka, Aleksić Aleksandar
Helath Center Zajecar, Nuclear Medicine Services.
Med Pregl. 2011 Nov-Dec;64(11-12):533-8.
Amiodarone treatment is associated with the occurrence of thyroid dysfunction. The aim was to determine the incidence of amiodarone-induced thyroid dysfunctions and the influence of gender, age, treatment duration, goiter, thyroid antibodies, thyroid echogenicity and family history on their appearance. Of 248 consecutive patients, 144 males and 104 females, referred to thyroid status screening, 16% were with clinical dysfunction, 21% with sub-clinical dysfunction and 63% were euthyroid. The presence of goiter and thyroid peroxidase antibodies were the significant individual predictive factors for the occurrence of clinical dysfunction, and in the multivariate regression model, the presence of goiter was a significant predictive factor with the prognostic value of 80%. For sub-clinical dysfunction, the significant individual predictive factors were female gender and the presence of goiter, as well as in the multivariate regression model, with the prognostic value of 74.5% for female gender and 77.5 % for the presence of goiter. It is necessary to check the thyroid status both before and during amiodarone treatment. Administration of other anti-arrhythmic drugs and/or more frequent check-ups of the thyroid status should be taken into consideration in patients at higher risk, i.e. women with positive thyroid peroxidase antibodies and goiter.
胺碘酮治疗与甲状腺功能障碍的发生有关。目的是确定胺碘酮诱发的甲状腺功能障碍的发生率，以及性别、年龄、治疗持续时间、甲状腺肿、甲状腺抗体、甲状腺回声性和家族史对其出现的影响。在连续接受甲状腺状态筛查的248例患者中，男性144例，女性104例，16%有临床功能障碍，21%有亚临床功能障碍，63%甲状腺功能正常。甲状腺肿和甲状腺过氧化物酶抗体的存在是临床功能障碍发生的重要个体预测因素，在多变量回归模型中，甲状腺肿的存在是一个重要预测因素，预后价值为80%。对于亚临床功能障碍，重要的个体预测因素是女性性别和甲状腺肿的存在，在多变量回归模型中也是如此，女性性别的预后价值为74.5%，甲状腺肿存在的预后价值为77.5%。在胺碘酮治疗前和治疗期间都有必要检查甲状腺状态。对于高危患者，即甲状腺过氧化物酶抗体阳性且有甲状腺肿的女性，应考虑给予其他抗心律失常药物和/或更频繁地检查甲状腺状态。
