过度甲状腺功能低下的患者的生活质量. 一个系统的审查
Marianne Thvilum1, Sara Marcus Lind1, Eva Ebbehoj1
1Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200 Aarhus N, Denmark.
European journal of endocrinology
|September 5, 2025
概括
尽管接受了levothyroxine治疗,但甲状腺功能低下患者的生活质量仍然受损. 这一系统性审查突出了心理健康,身体健康和社会角色的持续问题, 即使得到最佳治疗.
科学领域:
- 内分泌学和新陈代谢
- 临床研究
- 健康成果研究
背景情况:
- 在用levothyroxine (LT4) 治疗的甲状腺功能低下患者中,持续的症状和生活质量 (QoL) 的降低越来越多.
- 了解治疗的甲状腺功能低下症的长期QOL结果对于患者的护理至关重要.
研究的目的:
- 对长期接受levothyroxine治疗的患有甲状腺功能低下症,特别是哈希莫托甲状腺炎 (HT) 或先天性甲状腺功能低下症 (CH) 的成年人生活质量的现有文献进行系统审查和元分析.
主要方法:
- 在PubMed和Embase进行了系统的文献搜索,使用关键词"甲状腺功能低下和生活质量".
- 包括的研究集中在至少6个月用levothyroxine治疗的HT或CH的成年患者中.
- 评估了生活质量领域 (心理健康,身体健康,社会角色),并使用随机效应模型进行了元分析.
主要成果:
- 这项审查包括17项研究 (14项关于HT,3项关于CH).
- 经常报告精神健康 (10项研究) 和身体健康 (10项研究) 的下降.
- 在7项研究中发现社会角色受损. 在13项研究中存在方法上的缺陷,尽管结论得到了强有力的研究元分析的支持.
结论:
- 尽管文献上存在方法上的局限性,但甲状腺功能低下症患者的生活质量显著下降.
- 未来的研究应解决残留偏差,并探索疾病病因,持续时间和并发症等因素,以确定治疗反应不足的患者群体并改善QOL.
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