患有DTC的患者的TSH变异性和心房动:区域队列研究
Maximilian Zoltek1, Therese M-L Andersson2, Christel Hedman3,4,5
1Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm, 17176 Sweden.
概括
这项研究检查了差异化甲状腺癌 (DTC) 患者的甲状腺刺激激素 (TSH) 水平及其与心房动 (AF) 的联系. 在DTC幸存者中,TSH抑制和AF风险之间没有明确的关联.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 在瘤学瘤学.
背景情况:
- 差异化甲状腺癌 (DTC) 管理通常涉及甲状腺刺激激素 (TSH) 抑制.
- 与TSH抑制相关的潜在心血管风险,包括心房动 (AF),需要在DTC患者中进一步调查.
研究的目的:
- 在DTC患者中定量分析TSH水平.
- 调查TSH水平与DTC患者发生AF风险之间的相关性.
主要方法:
- 在瑞典斯德哥尔摩,1995-2015年间诊断的608名DTC患者的回顾性分析.
- TSH水平分为未抑制,轻度抑制或抑制;随访时间长达10年.
- 嵌套病例控制研究,以评估TSH类别对发生的AF的影响,包括心血管风险因素.
主要成果:
- 大约78%的患者在随访期的一半以上保持了抑制的TSH水平.
- 在2013年之后,TSH抑制率的下降被观察到,与个性化治疗方法相吻合.
- 在39例发生的AF病例中,大多数发生在患有抑制TSH的患者中;大约一半的患者有先前存在的心血管风险因素.
结论:
- DTC患者在很大程度上遵循TSH抑制指南,在2013年后抑制率降低.
- 该研究没有确定TSH抑制与DTC患者发生的AF风险之间的明确联系.
- 需要进一步的研究来澄清TSH抑制和AF在这个人群之间的关系.
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