García R V, Gómez Sobreira M, Batista J, Moreiras M, Lázaro Enguis J, Alvarez Gándara D
Sección de Endocrinología, Hospital Xeral de Vigo.
Rev Esp Cardiol. 1990 Apr;43(4):227-30.
This is a prospective study of 132 patients, without previous thyroid dysfunction, chronically treated with amiodarone for cardiac arrhythmias, to determine the incidence of thyroid dysfunction. Age was 62 +/- 11 years (mean +/- SD); 54 were female and 78 male. The arrhythmia was supraventricular in 66%, ventricular in 26.5%, and both in 7.5%. Amiodarone dose was 2,390 +/- 65 mg/week, and follow-up 20 +/- 9 months (minimum 9 months). Thyroid status was evaluated at the onset and at regular intervals during follow-up by means of clinical indexes defined by Crooks et al and Billewicz et al. During follow-up 4 patients developed diagnostic indexes (two hyperthyroid and two hypothyroid) and seven more developed suggestive symptoms without reaching a diagnostic index. Biochemical serum determinations of thyroid function proved dysfunction in the four with diagnostic indexes, and were normal in the other seven. The prevalence of new thyroid dysfunction in patients chronically treated with amiodarone in our population is 3%, with equal incidence of hyper and hypofunction. This is the expected incidence for an area with adequate dietary iodine intake. The use of clinical indexes of thyroid dysfunction appear as a useful and economical means of following thyroid function in these patients, saving a large number of biochemical tests.
这是一项针对132例既往无甲状腺功能障碍、因心律失常长期服用胺碘酮患者的前瞻性研究，以确定甲状腺功能障碍的发生率。年龄为62±11岁（均值±标准差）；女性54例，男性78例。心律失常类型为室上性的占66%，室性的占26.5%，两者皆有的占7.5%。胺碘酮剂量为2390±65毫克/周，随访时间为20±9个月（最短9个月）。在研究开始时以及随访期间定期通过克鲁克斯等人和比莱维茨等人定义的临床指标评估甲状腺状态。随访期间，4例患者出现诊断指标（2例甲状腺功能亢进和2例甲状腺功能减退），另外7例出现提示性症状但未达到诊断指标。对4例有诊断指标患者的血清甲状腺功能进行生化测定证实存在功能障碍，另外7例结果正常。在我们的研究人群中，长期服用胺碘酮患者新出现甲状腺功能障碍的患病率为3%，甲状腺功能亢进和减退的发生率相同。这是碘摄入充足地区的预期发生率。使用甲状腺功能障碍的临床指标似乎是跟踪这些患者甲状腺功能的一种有用且经济的方法，可节省大量生化检测。
