放射性治疗后Graves轨道病的危险因素和结果
Hwa Young Ahn1, Jooyoung Lee2, Mina Kim2
1Department of Internal Medicine, Chung-ang University College of Medicine, Seoul, Republic of Korea.
Endocrine
|July 9, 2025
概括
对格雷夫斯病 (GD) 的放射性 (RAI) 治疗增加了格雷夫斯轨道病 (GO) 的风险,特别是在年轻的吸烟者中. 利沃甲状腺素的使用可能会降低这种风险,强调需要仔细选择和监测患者.
科学领域:
- 内分泌学 在内分泌学.
- 眼科医生 眼科 眼科
- 甲状腺疾病研究研究.
背景情况:
- 格雷夫斯轨道病 (GO) 是格雷夫斯病 (GD) 的一个常见并发症.
- 放射性 (RAI) 治疗GD可能会触发或恶化GO.
- 影响RAI后GO发展及其临床结果的因素需要进一步调查.
研究的目的:
- 为了确定GD患者在RAI治疗后GO的发病率.
- 为了确定与RAI之后的GO发展相关的风险因素.
- 为了比较在接受RAI与未接受RAI的患者中GO的临床结果.
主要方法:
- 使用韩国国家卫生信息系统数据 (2008-2020) 进行的回顾性队列研究.
- 包括接受RAI治疗的GD患者 (2008-2018) 随访至2020年.
- 使用考克斯比例危险模型进行风险因素分析和结果比较.
主要成果:
- 在12819名接受RAI治疗的GD患者中,3.5%患有GO,而在没有RAI治疗的1529,386名患者中,0.3%患有GO.
- 对于RAI GO后的显著风险因素包括年轻的年龄,较短的RAI时间和吸烟.
- 在RAI后使用levothyroxine与减少GO风险有关;在RAI后的GO患者需要更密集的治疗.
结论:
- 对GD的RAI治疗与GO的发病率较高有关,特别是在年轻人和吸烟者中.
- 早期RAI治疗和吸烟是关键的危险因素,而勒沃西可能具有保护作用.
- 优化患者选择,鼓励戒烟,确保及时进行激素替代和密切监测对于管理RAI后的GO风险至关重要.
相关概念视频
Synthesis and Regulation of Thyroid Hormones
5.1K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
5.1K
The Thyroid Gland
4.4K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
4.4K
Biological Effects of Radiation
16.1K
All radioactive nuclides emit high-energy particles or electromagnetic waves. When this radiation encounters living cells, it can cause heating, break chemical bonds, or ionize molecules. The most serious biological damage results when these radioactive emissions fragment or ionize molecules. For example, α and β particles emitted from nuclear decay reactions possess much higher energies than ordinary chemical bond energies. When these particles strike and penetrate matter, they...
16.1K
Functions of Thyroid Hormones
3.2K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
3.2K
Open Angle Glaucoma: Treatment
583
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
583


