甲状腺功能障碍和甲状腺毒性治疗中的酸盐:综合性综述
Giuseppe Lisco1, Giacomo Accardo2, Cinzia Pupilli3
1Interdisciplinary Department of Medicine, School of Medicine, University of Bari "Aldo Moro", Bari, 70124, Italy. giuseppe.lisco@uniba.it.
酸盐抑制的吸收,影响甲状腺激素的合成. 这一系统性审查表明,尽管证据有限,但甲酸盐可能作为特定甲状腺功能增强症病例的二线治疗,包括诱导的疾病和甲状腺风暴.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 甲酸盐是阻碍运输到甲状腺细胞的离子抑制剂,从而阻碍甲状腺激素的合成.
- 尽管有它们的作用机制,但与其他可用的干预措施相比,高酸盐通常不被认为是甲状腺功能障碍和甲状腺毒性病的第一线治疗方法.
研究的目的:
- 系统地审查现有的文献,并重新评估甲酸盐在治疗甲状腺功能过高和甲状腺毒性病的治疗作用.
主要方法:
- 搜索和检查了临床指南,以总结目前对甲酸盐在甲状腺功能障碍管理中的使用建议.
- 审查了随机和非随机临床试验,以评估高酸盐在治疗甲状腺功能障碍和甲状腺毒性病的疗效,有效性和安全性.
主要成果:
- 该审查考虑了特定的甲状腺功能障碍形式:格雷夫斯病,与怀孕有关的甲状腺功能障碍,对比诱导的甲状腺功能障碍,阿米奥达龙诱导的甲状腺功能障碍和甲状腺风暴.
- 大多数研究都表现出局限性,包括非受控设计,缺乏盲目化,参与者数量少,以及对心血管事件或致性等临床相关终点数据不足.
- 在怀孕期间,甲酸盐可以作为二线治疗选择,在胺胺,放射性或甲状腺切除术之后,用于 Graves 病和甲状腺功能障碍. 它们还显示出作为二线治疗与相关的甲状腺功能障碍和甲状腺风暴的潜力,单独或与其他药物结合使用.
结论:
- 甲酸盐可以考虑用于特定的甲状腺疾病,如诱导的甲状腺功能过高和甲状腺风暴.
- 目前支持甲酸盐使用的证据有限,需要在临床实践中谨慎考虑.
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