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[甲状腺次全切除术。胺碘酮所致甲状腺毒症中值得考虑的一种治疗方法]

[Subtotal thyroidectomy. A treatment to keep in mind in amiodarone-induced thyrotoxicosis].

作者信息

López Mínguez J R, Díaz Pérez de Madrid J, García Andoaín J M, García Guerrero J J, Morales Pérez F, Alvarez Suárez-Bárcenas J M, Altozano Gómez J C, Redondo Méndez A, Alonso Ruiz F

机构信息

Servicio de Cardiología, Hospital Infanta Cristina, Badajoz.

出版信息

Rev Esp Cardiol. 1996 Jun;49(6):474-6.

PMID:8753914
Abstract

Amiodarone is an antiarrhythmic drug, frequently used in cardiology, which may produce secondary effects on the thyroid function. These effects can range from subtle changes in peripheral hormones without clinical manifestations, to severe forms of hypothyroidism or hyperthyroidism. The evolution of amiodarone-induced-hyperthyroidism can be mild, requiring only the withdrawal of the drug, or very severe, requiring an aggressive therapy with multiple drugs which may in some cases be fatal in spite of this therapy. Recently, the increase in the usage of this drug has produced reports of severe amiodarone-induced-thyrotoxicosis requiring surgery in some cases (subtotal or total thyroidectomy). A case of amiodarone-induced-thyrotoxicosis in its more aggressive form, which required intensive pharmacological treatment ultimately combined with surgery, is presented here.

摘要

胺碘酮是一种抗心律失常药物,常用于心脏病学领域,它可能会对甲状腺功能产生继发性影响。这些影响范围广泛,从外周激素的细微变化而无临床表现,到严重的甲状腺功能减退或甲状腺功能亢进。胺碘酮所致甲状腺功能亢进的病情发展可能较为轻微,仅需停用药物即可,也可能非常严重,需要多种药物进行积极治疗,尽管如此,在某些情况下仍可能致命。最近,随着这种药物使用量的增加,有报道称在某些病例中(次全或全甲状腺切除术)出现了严重的胺碘酮所致甲状腺毒症。本文介绍了一例病情较为严重的胺碘酮所致甲状腺毒症病例,该病例需要强化药物治疗,最终联合手术治疗。

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