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2003 年至 2018 年韩国甲状腺功能亢进症的患病率、治疗状况和合并症:一项全国性人群研究。

Prevalence, Treatment Status, and Comorbidities of Hyperthyroidism in Korea from 2003 to 2018: A Nationwide Population Study.

机构信息

Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Endocrinol Metab (Seoul). 2023 Aug;38(4):436-444. doi: 10.3803/EnM.2023.1684. Epub 2023 Jul 12.

Abstract

BACKGRUOUND

This study aimed to investigate the changes of incidence and treatment of choice for hyperthyroidism from 2003 to 2018 and explore the treatment-related complications and concomitant comorbidities in South Korea using data from the National Health Insurance Service.

METHODS

This is a retrospective observational study. Hyperthyroidism was defined as a case having two or more diagnostic codes of thyrotoxicosis, with antithyroid drug intake for more than 6 months.

RESULTS

The average age-standardized incidence of hyperthyroidism from 2003 to 2018 was 42.23 and 105.13 per 100,000 men and women, respectively. In 2003 to 2004, hyperthyroidism was most often diagnosed in patients in their 50s, but in 2017 to 2018, people were most often diagnosed in their 60s. During the entire period, about 93.7% of hyperthyroidism patients were prescribed with antithyroid drugs, and meanwhile, the annual rates of ablation therapy decrease from 7.68% in 2008 to 4.56% in 2018. Antithyroid drug-related adverse events, mainly agranulocytosis and acute hepatitis, as well as complications of hyperthyroidism such as atrial fibrillation or flutter, osteoporosis, and fractures, occurred more often in younger patients.

CONCLUSION

In Korea, hyperthyroidism occurred about 2.5 times more in women than in men, and antithyroid drugs were most preferred as the first-line treatment. Compared to the general population, hyperthyroid patients may have a higher risk of atrial fibrillation or flutter, osteoporosis, and fractures at a younger age.

摘要

背景

本研究旨在利用韩国国家健康保险服务的数据,调查 2003 年至 2018 年期间甲状腺功能亢进症的发病率和治疗选择变化,并探讨治疗相关并发症和并存合并症。

方法

这是一项回顾性观察性研究。甲状腺功能亢进症的定义为有两个或多个甲状腺毒症的诊断代码,并服用抗甲状腺药物超过 6 个月的病例。

结果

2003 年至 2018 年,男性和女性的年龄标准化发病率分别为 42.23 和 105.13/100,000。2003 年至 2004 年,甲状腺功能亢进症最常发生在 50 多岁的患者中,但在 2017 年至 2018 年,最常发生在 60 多岁的患者中。在整个时期,约 93.7%的甲状腺功能亢进症患者被开出处方用抗甲状腺药物,与此同时,消融治疗的年增长率从 2008 年的 7.68%下降到 2018 年的 4.56%。抗甲状腺药物相关的不良反应,主要是粒细胞缺乏症和急性肝炎,以及甲状腺功能亢进症的并发症,如心房颤动或扑动、骨质疏松症和骨折,在年轻患者中更为常见。

结论

在韩国,女性发生甲状腺功能亢进症的比例约为男性的 2.5 倍,抗甲状腺药物是首选的一线治疗方法。与一般人群相比,甲状腺功能亢进症患者在年轻时可能有更高的心房颤动或扑动、骨质疏松症和骨折的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f8/10475966/201a8552cb8d/enm-2023-1684f1.jpg

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