甲状腺素的过度使用和临床指标指导成功的治疗中止
Sarantis Livadas1,2, Nicholas Angelopoulos3, Anastasios Kollias4
1Endocrine Unit, Athens Medical Center, Athens, Greece. sarantislivadas@gmail.com.
Journal of endocrinological investigation
|February 3, 2025
概括
过度使用Levothyroxine (LT4) 是很常见的. 低于3的T4RxDI得分预测了成功的LT4退出,这表明如果停止,长期甲状腺功能低下的风险最小.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 利沃甲状腺素 (LT4) 经常被用于治疗甲状腺功能低下症.
- 有相当数量的患者可能在没有确定的诊断的情况下在LT4上.
- 成功停止LT4治疗的预测因素尚未得到充分确立.
研究的目的:
- 为了确定预测成功的Levothyroxine (LT4) 戒断的因素.
- 评估不必要的LT4治疗的流行率.
主要方法:
- 在没有明确的甲状腺功能低下症诊断的LT4患者中,有802名患者停止了治疗.
- 患者被分为两组:A组 (跟踪4个月) 和B组 (4个月后的甲状腺,跟踪60个月).
- 再发性甲状腺功能低下症的定义是TSH>4.5mIU/L. 计算了甲状腺治疗歧视指数 (T4RxDI).
主要成果:
- 23%的患者 (182/802) 发生了复发性甲状腺功能低下症.
- A组的复发率为40%,而B组的复发率为7% (p < 0.001).
- 在A组中,T4RxDI<2.78预测了成功的戒断 (72%的灵敏度,66%的特异性),在B组中,T4RxDI<3.75 (100%的灵敏度,48%的特异性).
结论:
- 调查结果表明,人们严重过度使用莱沃激素 (LT4).
- 建议T4RxDI得分低于3作为成功停止LT4的预测指标.
- 如果甲状腺功能低下症在4个月内没有复发,中止可能是安全的.
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