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危及生命的阿米奥达龙诱导的甲状腺毒性病 - - 个性化治疗激进治疗方法
Marta Opalińska1, Jacek Pantofliński2, Grzegorz Sokołowski1
1Chair and Department of Endocrinology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Krakow, Poland.
Heliyon
|August 19, 2024
概括
阿米奥达龙诱导的甲状腺毒性病 (AIT) 可能危及生命. 紧急放射性 (131-I) 治疗是严重AIT不适合手术的患者的有效治疗方法.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 核医学是一种核医学.
背景情况:
- 艾米奥达龙是一种有效的抗心律失常药,可以引起严重的艾米奥达龙诱导的甲状腺毒性病 (AIT).
- AIT具有显著的风险,特别是在心脏病患者中.
- 紧急甲状腺切除术是指导方针推的治疗方法,由于麻醉的高风险,通常是不可行的.
研究的目的:
- 评估紧急甲状腺切除术和放射性 (131-I) 治疗在患有严重AIT和心脏状况恶化的患者中的临床结果.
- 评估131-I治疗作为高风险患者手术的替代方案的疗效.
主要方法:
- 在2014年至2022年期间,对75名因严重AIT住院的患者进行了回顾性分析.
- 对接受保守治疗,紧急甲状腺切除术或131-I治疗的患者进行评估.
- 甲状腺功能测试,心脏状况和治疗结果的分析.
主要成果:
- 在需要紧急激素治疗的20名患者中,有6人在治疗前死亡,6人接受了甲状腺切除术,8人成功接受了131-I治疗.
- 131-I疗法,通常与rhTSH刺激,用于对麻醉,耐火性心律失常或严重心力衰竭有禁忌的患者.
- 尽管在关键病例中放射性摄入量低,但131-I治疗成功.
结论:
- 对抗药物治疗的AIT迅速进行彻底治疗至关重要.
- 紧急131-I疗法是严重AIT患者的可行和有效的替代方案,由于麻醉风险,甲状腺切除术的候选人不佳.
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