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普萘洛尔及其他β受体阻滞剂在甲状腺功能亢进症中的治疗潜力

The Therapeutic Potential of Propranolol and Other Beta-Blockers in Hyperthyroidism.

作者信息

Szybiak-Skora Weronika, Miedziaszczyk Miłosz, Szałek Edyta, Lacka Katarzyna

机构信息

University Clinical Hospital in Poznan, Poznan University of Medical Sciences, 60-355 Poznan, Poland.

Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, 60-806 Poznan, Poland.

出版信息

Int J Mol Sci. 2025 Aug 27;26(17):8322. doi: 10.3390/ijms26178322.

Abstract

β-blockers have found wide application in cardiology, neurology, psychiatry, anaesthesiology, and endocrinology. Due to the reduction in excessive reactivity of the peripheral sympathetic nervous system, they have been used in the treatment of symptoms of hyperthyroidism. Significant efficacy in alleviating neuro-psychiatric symptoms associated with hyperthyroidism is attributed to propranolol, while cardiac symptoms are alleviated by both non-selective and cardioselective β-blockers. The aim of our study is to collect and summarise the existing knowledge on the role of β-blockers in patients with hyperthyroidism, with particular emphasis on pregnant patients, the group with iatrogenic hyperthyroidism, and patients after amiodarone. Due to their favourable safety profile, they appear to be a beneficial supplementary therapy to the treatment of hyperthyroidism in pregnant patients. β-blockers are also used in the treatment of complications of hyperthyroidism after amiodarone administration. They may influence the therapeutic process of amiodarone-induced hyperthyroidism itself, as well as being a therapeutic alternative to amiodarone in a cardiovascular context. By alleviating the symptoms associated with high doses of L-thyroxine, which are used, e.g., in. patients with thyroid cancer, β-blockers may make it possible to maintain low TSH values.

摘要

β受体阻滞剂在心脏病学、神经病学、精神病学、麻醉学和内分泌学领域有着广泛应用。由于外周交感神经系统过度反应性降低,它们已被用于治疗甲状腺功能亢进症状。普萘洛尔在缓解与甲状腺功能亢进相关的神经精神症状方面具有显著疗效,而非选择性和心脏选择性β受体阻滞剂均可缓解心脏症状。我们研究的目的是收集和总结关于β受体阻滞剂在甲状腺功能亢进患者中作用的现有知识,特别关注孕妇、医源性甲状腺功能亢进患者以及服用胺碘酮后的患者。由于其良好的安全性,它们似乎是孕妇甲状腺功能亢进治疗的有益辅助疗法。β受体阻滞剂还用于治疗服用胺碘酮后甲状腺功能亢进的并发症。它们可能会影响胺碘酮诱导的甲状腺功能亢进本身的治疗过程,并且在心血管方面是胺碘酮的一种治疗替代方法。通过缓解与高剂量L-甲状腺素相关的症状(例如在甲状腺癌患者中使用),β受体阻滞剂可能使维持低促甲状腺激素值成为可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9a1/12428384/1feaae6b647a/ijms-26-08322-g001.jpg

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