对于患有亚临床甲状腺功能低下症的退伍军人来说,Levothyroxine治疗开始的频率和决定因素
Andreea Terlea1, Freddy J K Toloza2,3, Richard R Owen1,4
1Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA.
Journal of clinical medicine
|October 16, 2024
概括
在10名退伍军人中,近3名患有亚临床甲状腺功能低下症 (SCH) 的退伍军人接受了levothyroxine治疗. 白人种族和较高的甲状腺激素水平与治疗开始的几率增加有关,这表明潜在的差异.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 亚临床甲状腺功能低下症 (SCH) 与过度治疗有关,需要对治疗模式进行调查.
- 了解影响SCH中levothyroxine启动的因素对于基于证据的实践至关重要.
研究的目的:
- 确定治疗亚临床甲状腺功能障碍症 (SCH) 的患者比例.
- 确定与SCH患者启动甲状腺激素治疗相关的关键决定因素.
主要方法:
- 分析了2016年1月1日至2018年12月31日期间被诊断患有SCH的成年退伍军人随机样本.
- 用单变量和多变量逻辑回归模型来确定与levothyroxine启动相关的因素.
- 评估了人口统计数据,甲状腺激素水平和甲状腺检测史.
主要成果:
- 在229名患有SCH的退伍军人中,有27.5%接受了勒沃西治疗.
- 白人种族 (OR=4.50) 和较高的甲状腺激素水平 (OR=1.71 每个SD增加) 与治疗几率的增加显著相关.
- 与未接受治疗的患者相比,Levothyroxine的启动通常基于单个异常的甲状腺测试,确认性甲状腺测试的频率较低,自身免疫测试的频率相似.
结论:
- 很大一部分患有SCH的退伍军人接受了levothyroxine治疗,通常没有全面的甲状腺评估.
- 治疗决策似乎受患者的种族和甲状腺激素升高的严重程度的影响.
- 这些发现表明潜在的种族差异,以及在管理亚临床甲状腺功能障碍时需要标准化指南.
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