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用于治疗双极性障碍和甲状腺功能障碍和慢性病的风险
Joe Kwun Nam Chan1, Marco Solmi2,3,4,5,6, Christoph U Correll5,7,8
1Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
JAMA network open
|February 11, 2025
概括
对双相情感障碍的治疗与甲状腺问题和慢性病 (CKD) 的风险增加有关. 确定了特定的血清水平值,有助于对患者进行个性化风险评估.
科学领域:
- 精神病学和药理学 精神病学和药理学
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
背景情况:
- 是双相情绪障碍 (BD) 的基石情绪稳定剂.
- 目前关于对甲状腺和脏功能的不良影响的数据有限且不一致.
- 需要将的风险与其他常用的药物进行比较,并确定安全的血清水平值.
研究的目的:
- 在亚洲人群中,研究用治疗的发生性双相情感障碍 (BD) 患者甲状腺和功能障碍的风险,与其他情绪稳定剂和抗精神病药物相比.
- 为了确定与甲状腺和脏并发症相关的特定血清水平切断值.
主要方法:
- 一项以人口为基础的回顾性队列研究是使用香港医疗记录 (2002-2018) 进行的.
- 分析了15岁以上发生BD的患者.
- 考克斯比例危险回归和接收器运行特征分析被用于评估风险并确定水平值.
主要成果:
- 与非治疗相比,使用与甲状腺功能低下症 (aHR,2.00) 和慢性病阶段3+ (CKD3+) (aHR,1.35) 的风险更高.
- 较高的血清水平与甲状腺功能低下症,甲状腺功能过高症和CKD3+的风险增加有关.
- 确定了甲状腺功能低下 (>0.5028 mEq/L),甲状腺功能高 (>0.5034 mEq/L) 和CKD3+ (>0.5865 mEq/L) 的血清水平值.
结论:
- 对BD的治疗与亚洲人群中甲状腺功能障碍和CKD风险轻微增加有关.
- 识别的血清水平值可以为基于证据的指导方针和针对BD治疗的个性化风险益处评估提供信息.
- 与相比,替代性情绪稳定剂如氨酸,奥兰扎宾,奎蒂亚平和RISPERIDONE显示这些并发症的风险概况通常较低.
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