患有下丘脑下垂体疾病的患者的亚临床中央甲状腺功能低下症:它是否存在?
Julio Abucham1, Manoel Martins2
1Neuroendocrine Unit, Endocrinology Division, Escola Paulista de Medicina - Universidade Federal de São Paulo-UNIFESP, São Paulo, São Paulo, Brazil.
Reviews in endocrine & metabolic disorders
|February 7, 2024
概括
亚临床的中央甲状腺功能低下症 (CH) 在患有下丘脑下垂体疾病的患者中很常见,即使FT4水平正常. 通过多普勒回声心脏成像检测到的延长的心脏时间间隔可以诊断这种情况.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 诊断生物标志物 诊断生物标志物
背景情况:
- 中枢甲状腺功能低下症 (CH) 是由于甲状腺 TSH 刺激不足造成的.
- 目前的诊断依赖于低FT4,该FT4对CH的敏感性较低.
- 心脏时间间隔,就像异体体缩时间 (ICT),反映了外围甲状腺激素的作用.
研究的目的:
- 调查患有下丘脑下垂体疾病的患者中亚临床CH的患病率和诊断.
- 评估心脏时间间隔作为亚临床心脏病诊断生物标志物的有用性.
- 质疑正常FT4水平的解释,不包括CH.
主要方法:
- 使用多普勒回声心脏学来测量心脏时间间隔,特别是ICT.
- 在患有下丘脑下垂体疾病和不同FT4水平的患者中分析了ICT.
- 在甲状腺素替代疗法后评估ICT的变化.
主要成果:
- 患有下丘脑下垂体疾病和正常FT4水平的高比例患者表现出长时间的ICT.
- ICT在甲状腺素治疗后正常化,证实其作为生物标志物的作用.
- 研究结果表明,在这个人群中,亚临床CH是常见的,即使在中等范围的FT4.
结论:
- 在患有下丘脑下垂体疾病和正常FT4水平的患者中,亚临床CH普遍存在.
- 长时间的ICT是亚临床CH的可靠诊断生物标志物.
- 多普勒心声学可以改善CH的诊断和监测,可能降低心血管风险.
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