在提奥纳米德抗甲状腺药物治疗期间持续的甲状腺功能低下症:比较短期和长期的美西马治疗
Navid Saadat1, Safdar Masoumi2,3, Mohammad Karim Shahrzad4
1Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
International journal of endocrinology and metabolism
|March 11, 2025
概括
与短期治疗相比,长期的甲基马治疗格雷夫斯甲状腺功能障碍导致甲状腺刺激激素 (TSH) 水平更持久. 这种改善的TSH控制可能会降低与甲状腺功能障碍相关的心血管风险.
科学领域:
- 内分泌学 在内分泌学.
- 甲状腺疾病 甲状腺疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 延长低血清甲状腺激素 (TSH) 水平与甲状腺功能过高患者心血管事件风险增加有关.
- 格雷夫斯甲状腺功能障碍的治疗需要仔细监测TSH水平.
研究的目的:
- 为了比较在Graves的甲状腺功能障碍患者中短期和长期的甲基马治疗之间的持续正常TSH度的持续时间.
- 评估不同甲基马治疗持续时间对甲状腺激素调节的长期疗效.
主要方法:
- 258名格雷夫斯甲状腺功能障碍患者接受了18-24个月的甲基马,然后随机选择停止 (短期,n=128) 或继续 (长期,n=130) 另外36-102个月.
- 在随机化后的132个月内,每6个月进行一次临床和实验室评估,包括TSH,自由甲状腺素和三甲状腺素.
主要成果:
- 长期治疗组实现了95.8%±7.0%的优甲状腺症时间,而短期治疗组的时间为90.4%±8.1% (P<0.001).
- 甲状腺功能障碍复发发生在短期组的54%,而长期组的18.5% (24名患者).
- 短期治疗组中接受levothyroxine的患者经历了最低的甲状腺功能缓解时间 (74.6%).
结论:
- 长期的甲基马治疗显著增加了与持续正常的血清TSH水平花费的时间在骨的甲状腺功能障碍患者.
- 延长治疗时间似乎更有效地维持甲状腺功能减弱症,并可能减轻心血管风险.
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