对在癫痫诊所就诊的服用苯妥英钠、卡马西平或丙戊酸钠的患者的甲状腺状态进行有效评估。
The effective evaluation of thyroid status in patients on phenytoin, carbamazepine or sodium valproate attending an epilepsy clinic.
作者信息
Connacher A A, Borsey D Q, Browning M C, Davidson D L, Jung R T
机构信息
University Department of Medicine, Ninewells Hospital Dundee Scotland, UK.
出版信息
Postgrad Med J. 1987 Oct;63(744):841-5. doi: 10.1136/pgmj.63.744.841.
To assess the most efficient means of monitoring thyroid status in an epilepsy clinic, total thyroxine (T4), free thyroxine stimulating hormone (TSH) were measured in 71 adult patients treated long-term with either phenytoin (DPH), carbamazepine (CBZ) or sodium valproate (VAL). Twenty-seven patients with one or more abnormal thyroid hormone results were further investigated by a thyrotrophin releasing hormone (TRH) test and clinical assessment. T4 was found to be normal in 85% on VAL, 40% on CBZ and 39% on DPH. FT4 was normal in more patients, namely 95% on VAL, 70% on CBZ and 65% on DPH. The TRH tests indicated that FT4 was the most efficient screening test for hypothyroidism in this epileptic population. We estimate that the use of FT4 alone as a screening test would have reduced by 60% the number of TRH tests required.
为评估在癫痫门诊监测甲状腺状态的最有效方法，对71例长期接受苯妥英（DPH）、卡马西平（CBZ）或丙戊酸钠（VAL）治疗的成年患者测定了总甲状腺素（T4）、游离甲状腺素和促甲状腺激素（TSH）。对27例甲状腺激素结果一项或多项异常的患者，通过促甲状腺激素释放激素（TRH）试验和临床评估作进一步检查。结果发现，接受VAL治疗的患者中85%的T4正常，接受CBZ治疗的为40%，接受DPH治疗的为39%。更多患者的游离甲状腺素（FT4）正常，接受VAL治疗的患者中95%正常，接受CBZ治疗的为70%，接受DPH治疗的为65%。TRH试验表明，FT4是该癫痫患者群体甲状腺功能减退症最有效的筛查试验。我们估计，仅使用FT4作为筛查试验，所需TRH试验的数量将减少60%。
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