在抗甲状腺药物治疗之后,对格雷夫斯甲状腺功能障碍的复发的预测
Huan Weng1, Wen Bo Tian2, Zi Dong Xiao1
1Department of Endocrinology, Shantou Central Hospital, Shantou, China.
Archives of endocrinology and metabolism
|May 30, 2023
概括
失眠,更大的喉,更高的TRAb水平和增加的甲基马剂量是抗甲状腺药物治疗后格雷夫斯病复发的关键风险因素. 解决这些问题可以改善患者的治疗结果.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 用抗甲状腺药物 (ATD) 治疗格雷夫斯病 (GD) 通常会导致戒断后的复发率高.
- 确定复发的预测因素对于有效的GD管理至关重要.
研究的目的:
- 在中国南部接受ATD治疗的患者中前性地调查GD复发的风险因素.
主要方法:
- 127名新诊断的GD患者 (>18岁) 接受了18个月的ATD,治疗后持续1年.
- 使用考克斯回归分析来确定复发的重大风险因素 (P < 0.05).
主要成果:
- 43%的患者 (55/127) 在ATD停用后一年内经历了GD复发.
- 显著的危险因素包括失眠 (HR 2.94),更大的喉大小 (HR 3.34),更高的TRAb标位 (HR 2.66) 和更高的维护甲基马剂量 (HR 2.14).
结论:
- 失眠成为GD复发的重要风险因素,独立于传统因素,如的大小,TRAb和MMI剂量.
- 进一步研究睡眠质量对GD预后的影响是有必要的.
相关概念视频
Synthesis and Regulation of Thyroid Hormones
4.8K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.8K
Desensitization and Tachyphylaxis
1.9K
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
1.9K
Functions of Thyroid Hormones
2.9K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.9K
The Thyroid Gland
4.0K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
4.0K
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
1.1K
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
1.1K


