在开始使用levothyroxine后持续症状的实践评估
Jessica Hidalgo1, Bryan A Vallejo2, Cristian Soto Jacome1
1Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota.
概括
许多接受levothyroxine (LT4) 治疗的甲状腺功能低下患者仍然会出现症状. 大约25%的甲状腺刺激激素 (TSH) 水平正常的患者报告持续或新的甲状腺功能低下症状,表明需要进一步研究.
科学领域:
- 内分泌学和新陈代谢学
- 甲状腺疾病 甲状腺疾病
- 药物治疗 药物治疗
背景情况:
- 利沃甲状腺素 (LT4) 是甲状腺功能低下症的主要治疗方法.
- 一些患者继续出现甲状腺功能低下症状,尽管在LT4治疗中达到正常的甲状腺刺激激素 (TSH) 水平.
研究的目的:
- 为了调查在开始LT4治疗后患有甲状腺功能低下症的患者持续或新症状的频率.
- 为了评估患有甲状腺功能低下症的患者中出现症状的发生,这些患者已经实现了euthyroid状态.
主要方法:
- 在梅奥诊所对356名患有甲状腺功能低下症的患者进行了回顾性研究,这些患者在2017年至2019年期间启动了LT4.
- 在LT4启动后,在最多三次随访中评估生化状态和症状.
- 对患者病历分析报告的症状和甲状腺刺激激素 (TSH) 水平.
主要成果:
- 显著比例的患者 (47.7%) 在基线报告了甲状腺功能低下的症状,疲劳是最常见的.
- 在随访期间,26.7%至28%的TSH水平正常的患者出现了持续或新的症状.
- 疲劳仍然是正常TSH和持续症状的患者中最经常报告的症状.
结论:
- 大约四分之一的患有甲状腺功能低下症的LT4治疗和正常TSH水平的患者经历了持续或新的症状.
- 对于这些持续性或新出现的症状的潜在原因,对于甲状腺功能良好的患者来说,仍然不清楚.
- 需要进一步的研究来了解病因学,并为这些患者制定有效的管理策略.
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