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甲状腺切除术后促甲状腺激素值高的患者的碘治疗:一项随机研究。

Iodine therapy for thyroidectomy patients exhibiting high thyroid-stimulating hormone values: a randomised study.

作者信息

Taylor J D, Radcliffe S N, Basu P K, Atkins P

机构信息

Royal Liverpool University Hospital.

出版信息

Ann R Coll Surg Engl. 1993 May;75(3):168-71.

Abstract

After thyroidectomy there is an appreciable incidence of hypothyroidism as judged by FT4I estimates. Pharmacological doses of iodine (10-300 mg/day) usually suppress, whereas physiological doses of iodine (< 5 mg/day) have been reported to both decrease and increase thyroid function. The value of iodine supplementation in preventing post-thyroidectomy hypothyroidism was assessed in a prospective randomised trial. A series of 55 patients with a TSH > 6 mU/l 1 month after bilateral subtotal thyroidectomy or unilateral lobectomy for benign disease were randomised to receive either chloroform water 5 ml/day (placebo) or chloroform water 5 ml/day with 1 mg of iodine to be taken for 20 weeks. With placebo, 62% of bilateral subtotal thyroidectomies were euthyroid at 6 months on no thyroid replacement, while with iodine all were hypothyroid as judged by FT4I. After bilateral subtotal thyroidectomy, the recovery of remnant function is delayed by an iodine supplement of 1 mg/day.

摘要

根据游离甲状腺素指数(FT4I)评估,甲状腺切除术后甲状腺功能减退的发生率相当可观。药理剂量的碘(10 - 300毫克/天)通常会产生抑制作用,而生理剂量的碘(<5毫克/天)据报道既能降低也能增强甲状腺功能。在一项前瞻性随机试验中评估了补充碘在预防甲状腺切除术后甲状腺功能减退方面的价值。一系列55例因良性疾病行双侧甲状腺次全切除术或单侧甲状腺叶切除术1个月后促甲状腺激素(TSH)>6 mU/L的患者被随机分组,分别接受每天5毫升氯仿水(安慰剂)或每天5毫升氯仿水加1毫克碘,持续服用20周。使用安慰剂时,62%接受双侧甲状腺次全切除术的患者在6个月时未接受甲状腺替代治疗的情况下甲状腺功能正常,而使用碘时,根据FT4I判断所有患者均出现甲状腺功能减退。双侧甲状腺次全切除术后,每天补充1毫克碘会延迟残余甲状腺功能的恢复。

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本文引用的文献

3
Iodide-induced thyrotoxicosis.碘致甲状腺毒症
Medicine (Baltimore). 1983 Jan;62(1):1-20. doi: 10.1097/00005792-198301000-00001.
4
Iodide-induced thyrotoxicosis in Boston.波士顿的碘致甲状腺毒症
N Engl J Med. 1972 Sep 14;287(11):523-7. doi: 10.1056/NEJM197209142871101.

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