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胺碘酮所致甲状腺功能障碍:临床最新进展

Amiodarone-Induced Thyroid Dysfunction: A Clinical Update.

作者信息

Elnaggar Mohamed Nabil, Jbeili Kahtan, Nik-Hussin Nik, Kozhippally Mohandas, Pappachan Joseph M

机构信息

Department of Endocrinology, Diabetes & Metabolism, University Hospitals of Morecambe Bay NHS Foundation Trust, United Kingdom, LA1 4RP.

Internal Medicine Department, Faculty of Medicine, Kafr El-Sheikh University, Kafr El-Sheikh, Egypt.

出版信息

Exp Clin Endocrinol Diabetes. 2018 Jun;126(6):333-341. doi: 10.1055/a-0577-7574. Epub 2018 Mar 20.

Abstract

Amiodarone is one of the most commonly prescribed antiarrhythmic agents in clinical practice owing to its efficacy, even with high toxicity profile. The high iodine content and the prolonged biological half-life of the drug can result in thyroid dysfunction in a high proportion of patients treated with amiodarone even after cessation of amiodarone. Both hypothyroidism and hyperthyroidism are common side effects that mandate regular monitoring of patients with thyroid function tests. Amiodarone-induced hypothyroidism (AIH) is diagnosed and managed in the same way as a usual case of hypothyroidism. However, differential diagnosis and clinical management of amiodarone-induced thyrotoxicosis (AIT) subtypes can be challenging. With the aid of a case snippet, we update the current evidence for the diagnostic work up and management of patients with amiodarone-induced thyroid dysfunction in this article.

摘要

胺碘酮是临床实践中最常用的抗心律失常药物之一,因其疗效显著,即便毒性较高。药物中的高碘含量和较长的生物半衰期会导致很大比例使用胺碘酮治疗的患者出现甲状腺功能障碍,即便在停用胺碘酮之后。甲状腺功能减退和甲状腺功能亢进都是常见的副作用,这就要求定期对患者进行甲状腺功能检测。胺碘酮所致甲状腺功能减退(AIH)的诊断和处理方式与一般甲状腺功能减退病例相同。然而,胺碘酮所致甲状腺毒症(AIT)各亚型的鉴别诊断和临床处理可能具有挑战性。借助一个病例片段,我们在本文中更新了关于胺碘酮所致甲状腺功能障碍患者诊断检查和处理的现有证据。

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