综述：放射学碘化造影剂诱发的甲状腺功能障碍
A review: Radiographic iodinated contrast media-induced thyroid dysfunction.
作者信息
Lee Sun Y, Rhee Connie M, Leung Angela M, Braverman Lewis E, Brent Gregory A, Pearce Elizabeth N
机构信息
Section of Endocrinology, Diabetes, and Nutrition (S.Y.L., L.E.B., E.N.P.), Boston University School of Medicine, Boston, Massachusetts 02118; Division of Nephrology and Hypertension (C.M.R.), Department of Medicine, University of California Irvine, Orange, California 92868; and Division of Endocrinology (A.M.L., G.A.B.), Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90095.
出版信息
J Clin Endocrinol Metab. 2015 Feb;100(2):376-83. doi: 10.1210/jc.2014-3292. Epub 2014 Nov 6.
CONTEXT
Thyroid hormone production is dependent on adequate iodine intake. Excess iodine is generally well-tolerated, but thyroid dysfunction can occur in susceptible individuals after excess iodine exposure. Radiological iodinated contrast media represent an increasingly common source of excess iodine.
OBJECTIVE
This review will discuss the thyroidal response after acute exposure to excess iodine; contrast iodine-induced thyroid dysfunction; risks of iodine-induced thyroid dysfunction in vulnerable populations, such as the fetus, neonate, and patients with impaired renal function; and recommendations for the assessment and treatment of contrast iodine-induced thyroid dysfunction.
METHODS
Data for this review were identified by searching PubMed, Google Scholar, and references from relevant articles from 1948 to 2014.
CONCLUSIONS
With the increase in the use of computed tomography scans in the United States, there is increasing risk of contrast-induced thyroid dysfunction. Patients at risk of developing iodine-induced thyroid dysfunction should be closely monitored after receiving iodinated contrast media and should be treated as needed.
背景
甲状腺激素的产生依赖于充足的碘摄入。过量碘一般耐受性良好，但易感个体在接触过量碘后可能会出现甲状腺功能障碍。放射性碘化造影剂是越来越常见的过量碘来源。
目的
本综述将讨论急性接触过量碘后的甲状腺反应；造影剂碘诱发的甲状腺功能障碍；胎儿、新生儿和肾功能受损患者等易感人群中碘诱发甲状腺功能障碍的风险；以及造影剂碘诱发甲状腺功能障碍的评估和治疗建议。
方法
通过检索1948年至2014年的PubMed、谷歌学术以及相关文章的参考文献来确定本综述的数据。
结论
随着美国计算机断层扫描使用的增加，造影剂诱发甲状腺功能障碍的风险也在增加。有发生碘诱发甲状腺功能障碍风险的患者在接受碘化造影剂后应密切监测，并应根据需要进行治疗。
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