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甲状腺功能和甲状腺功能过高治疗的患者的死亡率.

Jayne A Franklyn1, Michael C Sheppard, Patrick Maisonneuve

  • 1Division of Medical Sciences, University of Birmingham, England.

JAMA
|July 7, 2005
PubMed
概括
此摘要是机器生成的。

对甲状腺功能障碍的放射性治疗最初增加了死亡率,但这种风险随着甲状腺素 (T4) 治疗而减少. 建议治疗甲状腺功能障碍症以诱导甲状腺功能障碍症和随后的T4替换,特别是如果发生亚临床甲状腺功能障碍症.

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科学领域:

  • 内分泌学和新陈代谢学
  • 心血管健康 心血管健康
  • 公共卫生流行病学 流行病学

背景情况:

  • 甲状腺功能障碍与所有原因和循环死亡率的升高有关.
  • 这种增加的死亡率的可逆性和轻度甲状腺功能障碍或治疗诱导的甲状腺功能低下的影响尚不清楚.

研究的目的:

  • 调查甲状腺功能障碍的放射性治疗与死亡率之间的关联.
  • 评估使用甲状腺素 (T4) 治疗的轻度甲状腺功能障碍和甲状腺功能低下对死亡结果的影响.

主要方法:

  • 一项以人口为基础的队列研究,包括2668名40岁以上的40岁以上的个体,他们因甲状腺功能障碍而接受放射性治疗 (1984-2002).
  • 针对英格兰和威尔士的特定原因死亡率与特定年龄和特定时期死亡率的比较.
  • 分析T4治疗对放射性诱导的甲状腺功能低下和亚临床甲状腺功能障碍的死亡率的影响.

主要成果:

  • 与一般人群相比,放射性治疗组的总死亡率更高 (SMR 1.14).
  • 在T4治疗之前或没有T4治疗时观察到增加的死亡风险,但在T4治疗期间没有.
  • T4治疗与所有原因 (HR 0.65) 和循环死亡率 (HR 0.65) 的显著降低有关.

结论:

  • 甲状腺功能障碍的放射性治疗与死亡率的增加有关,随后的甲状腺素 (T4) 治疗可以减轻这种死亡率.
  • 通过足够的放射性剂量诱导明显的甲状腺功能低下症,然后进行T4替代是受支持的.
  • 在亚临床的甲状腺功能低下症中,放射性后的治疗可能会增加缺血性心脏病的死亡率,因此需要考虑T4替代.