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laparoscopic袖子胃切除术对甲状腺功能测试和肥胖患者的levothyroxine剂量的影响
Muhammed Taha Demirpolat1, Abdullah Sisik2
1General Surgery, University of Health Science, Umraniye Training and Research Hospital, Istanbul, TUR.
Cureus
|April 15, 2024
概括
laparoscopic袖子胃切除术 (LSG) 可以改善甲状腺功能在肥胖的患者甲状腺功能下降. 在LSG之后,许多患者可能会减少或停止服用勒沃西药物,由于体重减轻,需要调整剂量.
科学领域:
- 内分泌学 在内分泌学.
- 腹部外科 腹部外科
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 肥胖经常与甲状腺功能低下有关,通常用levothyroxine进行管理.
- 腹腔镜袖胃切除术 (LSG) 导致显著的体重减轻,可能会影响甲状腺激素水平和药物需求.
- 在甲状腺功能低和肥胖患者中,LSG对甲状腺功能和levothyroxine剂量的影响仍然是研究领域.
研究的目的:
- 研究LSG对血清甲状腺刺激激素 (TSH),自由甲状腺素 (FT4) 和自由三甲状腺素 (FT3) 水平在患有甲状腺功能低下的肥胖患者中的影响.
- 为了确定是否需要调整的Levothyroxine剂量后LSG由于体重减轻.
主要方法:
- 对51名患有甲状腺功能低下症的肥胖患者进行了回顾性分析,这些患者接受了Levothyroxine治疗,并接受了LSG.
- 在手术前和手术后六个月的体重,BMI,TSH,FT4,FT3和Levothyroxine剂量 (总和体重调整后) 的比较.
主要成果:
- 超过50%的患者停止了使用levothyroxine,近41%的患者需要在LSG后调整剂量.
- 在手术后六个月,观察到每周总量和体重调整后的勒沃西剂量显著减少 (p<0.001).
- 手术前的莱沃西剂量,多余体重减轻 (EWL%) 和缺乏高脂血症预测了体重调整后的莱沃西剂量的变化.
结论:
- 在肥胖个体中,LSG可以导致甲状腺功能测试的改善.
- 术后六个月,LSG可能会降低对体重调整的勒沃西剂量的需求.
- 建议对由于显著体重减轻而接受LSG的患者进行密切监测,以调整勒沃西的剂量.
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