Simonin R
Clinique médicale A, Hôpital de la Timone, Marseille.
Arch Mal Coeur Vaiss. 1989 Oct;82(10):1747-50.
The frequency of dysthyroidism during treatment with amiodarone makes it necessary to watch the thyroid gland, especially since that organ may apparently be intact in such cases. Clinical observation is insufficient owing to the patients's age and to the beta-blocking effect of amiodarone. Biochemical monitoring is accurate, but amiodarone-induced abnormalities without dysthyroidism (e.g. reverse T3 levels syndrome) must be taken into account. The key to the diagnosis lies in the study of free thyroid hormones (T3 and T4), notably the ultrasensitive TSH. It is possible, although not yet demonstrated, that measuring TSH levels might be sufficient.
胺碘酮治疗期间甲状腺功能紊乱的发生率较高,因此有必要对甲状腺进行监测,尤其是在甲状腺外观可能正常的情况下。由于患者年龄以及胺碘酮的β受体阻滞作用,临床观察并不充分。生化监测较为准确,但必须考虑到胺碘酮引起的无甲状腺功能紊乱的异常情况(如反T3水平综合征)。诊断的关键在于对游离甲状腺激素(T3和T4)的研究,尤其是超敏促甲状腺激素(TSH)。虽然尚未得到证实,但测量TSH水平可能就足够了。