由于未经治疗的甲状腺功能低下症导致的耐治疗的睡眠呼吸暂停
Marie Schouterden1, Fransien Van Hende2, Saartje Demolder3
1Department of Pneumology, Leuven University Center for Sleep and Wake disorders, University Hospitals Leuven, Leuven, Belgium.
Acta clinica Belgica
|July 3, 2025
概括
甲状腺功能低下症是经常被忽视的持续性睡眠呼吸暂停的原因. 治疗甲状腺激素缺乏症可以显著改善睡眠呼吸暂停症状,并降低剩余呼吸暂停-呼吸暂停指数 (AHI).
科学领域:
- 内分泌学 在内分泌学.
- 睡眠医学 睡眠医学
- 内部医学 内部医学
背景情况:
- 睡眠呼吸暂停,包括阻塞性 (OSA) 和中心性 (CSA),已经确立了诸如解剖学和神经肌肉因素,或心脏/神经疾病等原因.
- 内分泌疾病,特别是甲状腺功能低下症,经常被忽视为可能导致睡眠呼吸暂停的潜在因素.
- 严重的睡眠呼吸暂停会导致睡眠障碍和严重的心肺后果.
研究的目的:
- 突出甲状腺功能低下症是治疗耐药性睡眠呼吸暂停 (TRSA) 的可逆原因.
- 强调在睡眠呼吸暂停管理中考虑内分泌疾病的重要性.
- 报告用甲状腺激素替代治疗严重睡眠呼吸暂停的成功治疗情况.
主要方法:
- 一个患者的病例报告,患有严重的,持续的睡眠呼吸暂停,耐受CPAP治疗.
- 临床和生化评估,以诊断严重的甲状腺功能低下症与myxedema.
- 在甲状腺激素替代疗法期间监测睡眠呼吸暂停参数和临床状态.
主要成果:
- 患者出现严重的睡眠呼吸暂停,包括阻塞性,中心性和混合性事件,尽管接受了CPAP治疗.
- 深度甲状腺功能低下的诊断得到了生化证实.
- 甲状腺激素替代疗法导致显著的临床改善,包括体重减轻,甲状腺功能正常化以及剩余呼吸暂停-呼吸暂停指数 (AHI) 的八个月减少.
结论:
- 治疗耐药性睡眠呼吸暂停的患者应考虑甲状腺功能低下症.
- 甲状腺激素替代疗法可以有效地改善睡眠呼吸暂停的严重程度.
- 建议在被诊断为睡眠呼吸暂停的患者进行常规甲状腺功能查.
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