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[使用超敏促甲状腺激素测量研究胺碘酮对甲状腺功能的长期影响。初步报告]

[Study of the long-term effects of amiodarone on thyroid function using ultrasensitive TSH measurements. Preliminary report].

作者信息

Vogt T, Althaus B, Engler H, Burkart F, Girard J, Staub J J

机构信息

Department für Innere Medizin, Universitätskliniken, Kantonsspital, Basel.

出版信息

Schweiz Med Wochenschr. 1988 Dec 17;118(50):1909-11.

PMID:3222684
Abstract

The results of a prospective study of basal ultrasensitive TSH concentrations in patients during long-term treatment over 12 months with amiodarone are reported. 2 patients (3%) developed hypothyroidism, whereas no case of hyperthyroidism was observed. A significant increase in FT4 with a simultaneous decrease in T3 was demonstrated at every periodic investigation during amiodarone therapy. In most patients ultrasensitive TSH values stayed within the normal range and showed no significant alteration during treatment. A slow decline in TSH during therapy was observed in a subgroup of patients with completely euthyroid initial TSH concentrations. This TSH decrease reached statistical significance after 12 months' therapy. FT4 showed pathological results in 35% of all determinations at any time during the study, T3 in 27%, and TSH in only 17%. In conclusion, a new steady-state of thyroid tests is attained during treatment with amiodarone and most patients maintain a euthyroid function state. Assessment of ultrasensitive TSH can be recommended as a primary screening test for evaluation of thyroid function in patients under amiodarone therapy.

摘要

报告了一项前瞻性研究的结果,该研究针对使用胺碘酮进行超过12个月长期治疗的患者的基础超敏促甲状腺激素(TSH)浓度。2例患者(3%)出现甲状腺功能减退,而未观察到甲状腺功能亢进病例。在胺碘酮治疗期间的每次定期检查中,均显示游离甲状腺素(FT4)显著升高,同时三碘甲状腺原氨酸(T3)降低。大多数患者的超敏TSH值保持在正常范围内,且在治疗期间无显著变化。在初始TSH浓度完全正常的患者亚组中,观察到治疗期间TSH缓慢下降。治疗12个月后,这种TSH下降达到统计学意义。在研究期间的任何时候,FT4在所有测定中有35%显示异常结果,T3为27%,TSH仅为17%。总之,在胺碘酮治疗期间会达到甲状腺检查的新稳态,且大多数患者维持甲状腺功能正常状态。对于接受胺碘酮治疗的患者,推荐将超敏TSH评估作为评估甲状腺功能的主要筛查试验。

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