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对比剂对甲状腺功能的影响 - - 一项前性研究
Jeanette Carlqvist1,2, Ulf Nyman3, John Brandberg1,2
1Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
对比介质 (ICM) 很少在50-65岁的成年人中引起甲状腺功能障碍. 大多数病例是轻度和无症状的,很少出现亚临床问题,特别是在充足的地区.
科学领域:
- 放射学 放射学是一门学科.
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
背景情况:
- 对比剂 (ICM) 可能会诱导甲状腺功能障碍由于过多的.
- 关于对比引起的甲状腺功能障碍 (CITD) 的先前研究受到观察性和回顾性设计的限制.
- 瑞典心肺生物图像研究 (SCAPIS) 为评估CITD提供了一个前性队列.
研究的目的:
- 为了前性地评估对比引起的甲状腺功能障碍的发病率,严重程度和临床影响.
- 为了评估甲状腺激素水平和与甲状腺相关的症状后对比增强冠状动脉CT血管造影 (CCTA).
- 为了确定与ICM诱导的甲状腺功能障碍相关的风险因素.
主要方法:
- 在422个个体中,在CCTA前后分析甲状腺激素水平.
- 对368名参与者进行了与甲状腺有关的患者报告结果问卷 (ThyPRO).
- 测量甲状腺过氧化酶抗体 (TPOab) 和甲状腺超声波以检测结节.
主要成果:
- 观察到对甲状腺激素水平的小,统计学上显著的影响,没有明显的低甲状腺或甲状腺功能障碍.
- 亚临床甲状腺功能障碍或孤立的自由甲状腺素 (fT4) 水平变化发生在3.5%的个体中,没有增加症状.
- 升高的TPOab和出生在国外是亚临床甲状腺功能低下症的危险因素;甲状腺结节与ICM诱导的功能障碍无关.
结论:
- 对比诱导的甲状腺功能障碍是罕见的,通常是轻微的,自我限制的,在50-65岁的充足的人群中通常是无症状的.
- 使用SCAPIS队列的前性评估提供了关于ICM对甲状腺功能影响的可靠数据.
- 这些发现支持ICM的使用在这个人群中对于甲状腺功能通常是安全的.
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