治疗患有或没有心理健康问题的个体的亚临床甲状腺功能低下症 - - 一项基于德尔菲的两国专家共识研究
Ingrid Lieber1, Christina Maria Van Der Feltz-Cornelis2,3,4,5,6, Salman Razvi7
1Department of Clinical Sciences, Division of Psychiatry, Sunderby Research Unit, Umeå University, Umeå, Sweden.
Frontiers in endocrinology
|July 28, 2023
概括
关于诊断和治疗亚临床甲状腺功能低下症 (SCH) 的共识仍然难以达成. 专家们同意抗体查,但不同意甲状腺激素替代疗法的TSH值,这表明需要重新考虑SCH管理.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 临床实践指南 临床实践指南
背景情况:
- 亚临床甲状腺功能低下症 (SCH) 是一种普遍存在的内分泌疾病,影响4-20%的人口.
- 症状往往是不特定的,影响健康,导致频繁的医疗咨询.
- 甲状腺激素替代疗法 (THRT) 对SCH的疗效尚不确定,有争议的指导方针和有限的遵守.
研究的目的:
- 建立关于诊断和治疗亚临床甲状腺功能低下症 (SCH) 的临床共识.
- 探索有关SCH在有或没有情绪障碍或焦虑症的患者中管理的专家意见.
- 在全科医生,内分泌学家和精神病学家之间确定共识和分歧的领域.
主要方法:
- 采用了经过三轮修改的Delphi方法.
- 来自瑞典和英国的60名全科医生,内分泌学和精神病学专家参加了会议.
- 在26个关于SCH诊断和治疗的实践陈述上寻求共识.
主要成果:
- 在五个声明上达成共识,包括需要重复测试SCH诊断和抗体查的实用性.
- 据认为,抗体查加强了SCH患者THRT的适应性,无论是否有情感障碍.
- 关于启动THRT时的TSH值≥20mIU/L出现了重大分歧.
结论:
- 关于SCH诊断和治疗的不同态度仍然存在,强调需要重新考虑SCH的概念.
- 关于治疗值的分歧表明需要更好地了解甲状腺生理学.
- 目前的科学证据是不确定的,强调SCH管理指南应谨慎解释.
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