每周服用左甲状腺素治疗原发性甲状腺功能减退症：一项随机、单盲、交叉研究。
Treating primary hypothyroidism with weekly doses of levothyroxine: a randomized, single-blind, crossover study.
作者信息
Bornschein Andressa, Paz-Filho Gilberto, Graf Hans, Carvalho Gisah A de
机构信息
Serviço de Endocrinologia e Metabologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
出版信息
Arq Bras Endocrinol Metabol. 2012 Jun;56(4):250-8. doi: 10.1590/s0004-27302012000400006.
OBJECTIVE
Compliance to levothyroxine treatment in hypothyroidism is compromised by daily schedule, and a weekly dose may be an alternative.
SUBJECTS AND METHODS
This was a randomized, crossover study. Fourteen females were assigned to daily or weekly doses of LT4. After six weeks, they switched regimens. Thyroid parameters were measured at baseline, and after 42 and 84 days. Echocardiogram and hyperthyroidism symptoms were evaluated before and four hours after LT4 intake.
RESULTS
In the weekly dose treatment, fT4 levels were higher after taking LT4, and lower seven days after the last dose; by the 6(th) week there was a small decrease in T3 levels. TSH remained unchanged and there were no hyperthyroidism symptoms or echocardiographic manifestations.
CONCLUSION
Weekly dose leads to transient increases in fT4, without hyperthyroidism or cardiac symptoms. That approach seems to be a safe alternative for the treatment of hypothyroidism.
目的
甲状腺功能减退症患者服用左甲状腺素的依从性受每日服药计划影响，每周一次给药可能是一种替代方案。
对象与方法
这是一项随机交叉研究。14名女性被分配接受左甲状腺素每日或每周一次给药。六周后，她们更换治疗方案。在基线、42天和84天后测量甲状腺参数。在服用左甲状腺素前及服药后4小时评估超声心动图及甲状腺功能亢进症状。
结果
在每周一次给药治疗中，服用左甲状腺素后游离甲状腺素（fT4）水平升高，最后一次给药7天后降低；到第6周时三碘甲状腺原氨酸（T3）水平略有下降。促甲状腺激素（TSH）保持不变，且无甲状腺功能亢进症状或超声心动图表现。
结论
每周一次给药导致fT4短暂升高，无甲状腺功能亢进或心脏症状。该方法似乎是治疗甲状腺功能减退症的一种安全替代方案。
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