酸盐结合剂影响甲状腺下腺症患者的Levothyroxine吸收,患者患有末期脏疾病
Michelle Ko1, Rakhee Barai1, Gregory Brent1
1Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
Cureus
|November 15, 2024
概括
末期病 (ESRD) 和甲状腺功能低下症患者通常具有不规律的甲状腺刺激激素 (TSH) 水平. 切换到液体Levothyroxine在接受sevelamer的血液透析患者中改善了TSH控制.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 末期病 (ESRD) 与甲状腺功能低下的发病率增加有关.
- 在ESRD患者中甲状腺刺激激素 (TSH) 的升高与死亡率和心血管疾病等不良结果相关.
- 橋本氏病是甲状腺功能低下症的常見原因之一.
研究的目的:
- 报告一个患有ESRD和哈希莫托病的血液透析患者的病例,尽管服用高剂量Levothyroxine,但TSH水平不稳定.
- 为了研究酸盐结合剂sevelamer对levothyroxine吸收的影响.
- 评估切换到液体Levothyroxine配方在管理TSH水平的有效性.
主要方法:
- 一个患有ESRD的患者在血液透析和哈希莫托病的病例报告.
- 血清TSH和自由甲状腺素水平的监测.
- 服用口服的勒沃西和塞维拉默的使用.
- 从传统的勒沃西过渡到液体制剂.
主要成果:
- 患者表现出持续升高和不稳定的TSH水平,尽管坚持高剂量Levothyroxine.
- 塞维拉默的使用被确定为降低甲素吸收的潜在原因.
- 切换到液体牛甲状腺素导致自由甲状腺素正常化,并在两个月内改善了TSH水平.
结论:
- 在ESRD患者中甲状腺功能低下症的管理需要仔细考虑药物相互作用.
- 塞维拉默可以损害勒沃甲状腺素的吸收,导致TSH控制不足.
- 液体Levothyroxine制剂可能提供一个有效的替代方案,以改善TSH水平在吸收问题患者.
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