成人甲状腺功能减退症的诊疗

doi:10.3969/j.issn.1004-583X.2016.03.008

临床荟萃 ›› 2016, Vol. 31 ›› Issue (3): 262-267.doi: 10.3969/j.issn.1004-583X.2016.03.008

成人甲状腺功能减退症的诊疗

孟凤苓

河北医科大学第二医院内分泌科,河北石家庄 050011

收稿日期:2015-11-25 出版日期:2016-03-05 发布日期:2016-04-18
通讯作者: 孟凤苓,Email:fengling702@sina.com
作者简介:孟凤苓，河北医科大学第二医院内分泌科主任医师、教授，医学硕士，硕士研究生导师；石家庄市医学会糖尿病专业委员会委员，河北省中老年保健协会骨质疏松及相关疾病专业委员会常委。作为第一主研人曾承担卫生厅和院级指令性课题共四项，获河北省医学会优秀医学科技成果奖2项，参编医学著作7部；主要研究方向为甲状腺疾病，以第一作者发表学术论文30余篇。

Adult’s hypothyroidism: progress in diagnosis and treatment

Meng Fengling

Department of Endocrinology, the Second Hospital of Hebei Medical University, Shijiazhuang 050011, China

Received:2015-11-25 Online:2016-03-05 Published:2016-04-18
Contact: Meng Fengling, Email: fengling702@sina.com

摘要/Abstract

摘要： 甲状腺功能减退症(甲减)是内分泌科常见病,临床型甲减需要积极治疗,亚临床甲减在特定情况下也需要干预。左甲状腺素钠(Levothyroxine Sodium, L-T4)替代治疗是主要治疗对策,某些药物和食物会影响其吸收或利用,应注意服用方法。新的治疗方法在不断探索中,随着循证医学证据的不断积累,临床治疗对策也会日臻完善。

关键词: 心房颤动, 导管消融术, 甲状腺功能减退症, 甲状腺素, 治疗

Abstract: Hypothyroidism is a common disease in endocrinology, clinical hypothyroidism requires active treatment, under certain circumstances, subclinical hypothyroidism also needs intervention. Replacement therapy of levothyroxine sodium is a major countermeasure,while certaindrugs and foods may affect its absorption or use, taking method should have more attention. As the new treatment is constantly exploring,with the accumulation of evidence-based medicine, clinical treatment method will be improved gradually.

Key words: atrialfibrillation, radiofrequencycatheterablation, hypothyroidism, thyroxine, therapy

中图分类号:

R581.2

孟凤苓. 成人甲状腺功能减退症的诊疗[J]. 临床荟萃, 2016, 31(3): 262-267.

Meng Fengling. Adult’s hypothyroidism: progress in diagnosis and treatment[J]. Clinical Focus, 2016, 31(3): 262-267.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2016.03.008

https://huicui.hebmu.edu.cn/CN/Y2016/V31/I3/262

参考文献

[1] Mansourian AR. A review on the metabolic disorders of iodine deficiency[J]. Pak J Biol Sci,2011,14(7): 412-424.
[2] Fiore E, Tonacchera M, Vitti P. Influence of iodization programmes on the epidemiology of nodular goitre[J]. Best Pract Res Clin Endocrinol Metab,2014,28(4): 577-588.
[3] Thomson CD, Campbell JM, Miller J, et al. Minimal impact of excess iodate intake on thyroid hormones and selenium status in older New Zealanders[J]. Eur J Endocrinol,2011,165(5): 745-752.
[4] Kaneshige T, Arata N, Harada S, et al. Changes in serum iodine concentration, urinary iodine excretion and thyroid function after hysterosalpingography using an oil-soluble iodinated contrast medium (lipiodol)[J]. J Clin Endocrinol Metab,2015,100(3): E469-472.
[5] Cooper DS,Biondi B. Subclinical thyroid disease[J]. Lancet,2012,379(9821):1142-1154.
[6] Eastman CJ. Screening for thyroid disease and iodine deficiency[J]. Pathology,2012,44(2): 153-159.
[7] Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association[J]. Thyroid,2012,22(12): 1200-1235.
[8] Sijbom M, van Lieshout J, Felix-Schollaart B, et al. Summary of the 'Thyroid disorders' guideline of the Dutch College of General Practitioners' (NHG) [J]. Ned Tijdschr Geneeskd, 2013,157(35): A6667.
[9] Sukumar R, Agarwal A, Gupta S, et al. Prediction of LT4 replacement dose to achieve euthyroidism in subjects undergoing total thyroidectomy for benign thyroid disorders[J]. World J Surg,2010,34(3): 527-531.
[10] Devdhar M, Drooger R, Pehlivanova M, et al. Levothyroxine replacement doses are affected by gender and weight, but not age[J]. Thyroid,2011,21(8): 821-827.
[11] Hoang TD, Olsen CH, Mai VQ, et al. Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study[J]. J Clin Endocrinol Metab,2013,98(5): 1982-1990.
[12] 王可可. 口服左甲状腺素钠需要注意的问题[J]. 药品评价,2014,11(3): 42-45.
[13] Vita R, Saraceno G, Trimarchi F, et al. A novel formulation of L-thyroxine (L-T4) reduces the problem of L-T4 malabsorption by coffee observed with traditional tablet formulations[J]. Endocrine,2013, 43(1): 154-160.
[14] Abi-Abib RC, Vaisman M. Is it necessary to increase the dose of levothyroxine in patients with hypothyroidism who use omeprazole?[J]. Arq Bras Endocrinol Metabol,2014,58(7): 731-736.
[15] Cellini M, Santaguida MG, Gatto I, et al. Systematic appraisal of lactose intolerance as cause of increased need for oral thyroxine[J]. J Clin Endocrinol Metab,2014,99(8): E1454-1458.
[16] Bolk N, Visser TJ, Nijman J, et al. Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial[J]. Arch Intern Med,2010,170(22): 1996-2003.
[17] Wiersinga WM, Duntas L, Fadeyev V, et al. 2012 ETA Guidelines: the Use of L-T4 + L-T3 in the treatment of hypothyroidism[J]. Eur Thyroid J,2012, 1(2): 55-71.
[18] Wartofsky L. Combination L-T3 and L-T4 therapy for hypothyroidism[J]. Curr Opin Endocrinol Diabetes Obes,2013,20(5): 460-466.
[19] Biondi B, Wartofsky L. Combination treatment with T4 and T3: toward personalized replacement therapy in hypothyroidism[J]. J Clin Endocrinol Metab,2012, 97(7): 2256-2271.
[20] Solter D, Solter M. Benefit of combined triiodothyronine (LT(3)) and thyroxine (LT(4)) treatment in athyreotic patients unresponsive to LT(4) alone[J]. Exp Clin Endocrinol Diabetes,2012,120(2): 121-123.
[21] Celi FS, Zemskova M, Linderman JD, et al. The pharmacodynamic equivalence of levothyroxine and liothyronine: a randomized, double blind, cross-over study in thyroidectomized patients[J]. Clin Endocrinol (Oxf),2010,72(5): 709-715.
[22] Celi FS, Zemskova M, Linderman JD, et al. Metabolic effects of liothyronine therapy in hypothyroidism: a randomized, double-blind, crossover trial of liothyronine versus levothyroxine[J]. J Clin Endocrinol Metab,2011,96(11): 3466-3474.
[23] Fadeyev VV, Morgunova TB, Melnichenko GA, et al.Combined therapy with L-thyroxine and L-triiodothyronine compared to L-thyroxine alone in the treatment of primary hypothyroidism[J]. Hormones (Athens),2010,9(3): 245-252.
[24] Shakoor SK, Aldibbiat A, Ingoe LE, et al. Endothelial progenitor cells in subclinical hypothyroidism: the effect of thyroid hormone replacement therapy[J]. J Clin Endocrinol Metab,2010,95(1): 319-322.
[25] Wiersinga WM. Cardiovascular risks in patients with subclinical thyroid dysfunction [J]. Ned Tijdschr Geneeskd,2012,156(49): A5477.
[26] Hofling DB, Chavantes MC, Juliano AG, et al. Low-level laser in the treatment of patients with hypothyroidism induced by chronic autoimmune thyroiditis: a randomized, placebo-controlled clinical trial[J]. Lasers Med Sci,2013,28(3): 743-753.
[27] Hofling DB, Chavantes MC, Juliano AG, et al. Low-level laser therapy in chronic autoimmune thyroiditis: a pilot study[J]. Lasers Surg Med,2010,42(6): 589-596.
[28] Singh P, Singh B, Dave R, et al.The impact of yoga upon female patients suffering from hypothyroidism[J]. Complement Ther Clin Pract,2011,17(3): 132-134.
[29] Cornelli U, Belcaro G, Ledda A, et al. Activity of some physiological modulators in reducing the side effects of levothyroxine in patients suffering from primary hypothyroidism[J]. Panminerva Med,2011,53(3 Suppl 1): 99-103.
[30] Bornschein A, Paz-Filho G, Graf H, et al. Treating primary hypothyroidism with weekly doses of levothyroxine: a randomized, single-blind, crossover study[J]. Arq Bras Endocrinol Metabol,2012,56(4): 250-258.

成人甲状腺功能减退症的诊疗

Adult’s hypothyroidism: progress in diagnosis and treatment

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	王奕涵, 秦旭雁, 韩宣泽, 王樱洁, 高菲菲, 陈春红, 张岭楠, 张芳. 利伐沙班用于HASBLED评分≥3分的高龄非瓣膜性心房颤动患者的有效性和安全性[J]. 临床荟萃, 2024, 39(2): 121-124.
[2]	李雯琳, 张志. 心房颤动患者左心耳形态结构和功能与左心耳血栓及心源性卒中的关系研究进展[J]. 临床荟萃, 2024, 39(2): 168-171.
[3]	金鑫, 吴金玲, 尹丽丽. 持续性植物状态促醒机制及治疗研究进展[J]. 临床荟萃, 2024, 39(2): 172-176.
[4]	王琦, 陈宏. 维生素D在支气管哮喘和慢性阻塞性肺疾病治疗中的应用进展[J]. 临床荟萃, 2024, 39(1): 88-91.
[5]	崔兰丹, 杨春燕. 脓毒症患者甲状腺激素的变化特点及研究进展[J]. 临床荟萃, 2024, 39(1): 70-74.
[6]	邹子良, 余海, 王迪, 褚泰运, 李驹, 钱宝堂. 冠状动脉慢性完全闭塞病变介入治疗研究现状[J]. 临床荟萃, 2024, 39(1): 80-83.
[7]	游琪琪, 霍丽娟. 原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征的诊治进展[J]. 临床荟萃, 2024, 39(1): 84-87.
[8]	王鑫, 张展, 刘铎, 谢萍. 铁缺乏与肺动脉高压相关性的研究进展[J]. 临床荟萃, 2023, 38(9): 838-844.
[9]	陈聪水, 李园, 陈淑芳. 重视儿童胆源性胰腺炎的中西医诊治(附1例分析)[J]. 临床荟萃, 2023, 38(8): 726-730.
[10]	武锐锋, 刘宇宏. PDZ结合激酶/T淋巴细胞因子激活的杀伤细胞源性蛋白激酶的作用机制及其在肿瘤治疗中的潜在价值[J]. 临床荟萃, 2023, 38(8): 763-768.
[11]	侯有玲, 李奕, 关红玉, 罗红霞. 目标导向液体治疗在脑肿瘤切除术中应用效果的meta分析[J]. 临床荟萃, 2023, 38(8): 686-693.
[12]	王玥, 陈辉, 岑奕, 张哲, 张欣, 李宗锡, 陈珍珍, 贾彤彤, 章美玲. 超声引导下侧入路颈脊神经后支三氧联合注射松解治疗颈脊神经后支源性慢性颈肩痛[J]. 临床荟萃, 2023, 38(8): 714-718.
[13]	张会, 丁东瑞, 金天然. 新型冠状病毒SARS-CoV-2的相关研究——过去与未来[J]. 临床荟萃, 2023, 38(7): 638-646.
[14]	郭文惠, 雷皓月, 潘友卓, 张琦. 质膜膜泡关联蛋白的生物学功能研究进展[J]. 临床荟萃, 2023, 38(7): 647-653.
[15]	陈瑾, 吕鸿雁, 刘晗, 刘建宁, 卢佳配, 张金巧. 靶向BCMA的嵌合抗原受体T细胞治疗三重难治性多发性骨髓瘤的研究进展[J]. 临床荟萃, 2023, 38(7): 654-658.