胺碘酮诱发甲状腺功能亢进症32例临床分析

Clinical Analysis of 32 Cases of Amiodarone-Induced Hyperthyroidism

目的:探讨胺碘酮诱发的甲状腺功能亢进症(AIT)的临床进程和预后因素。方法:回顾性分析我院32例有完整资料的胺碘酮诱发的甲状腺功能亢进症患者,对其临床特征、实验室参数、治疗方法和随访过程中的事件发生率进行评估,以和AIT相关的并发症如:死亡、心衰住院、中风、心律失常等作为观察终点。结果:32例病人中有11例接受强的松治疗,但血清游离甲状腺素恢复正常的时间和非强的松治疗组比较没有差异,长期随访结果显示强的松治疗组具有较高的事件发生率。结论:胺碘酮诱发甲状腺亢进症具有较高的事件发生率,强的松治疗不能缩短血清甲状腺素恢复正常时间,反而增加不良事件发生率。

Objective： To explore the clinical course and prognosis of documented amiodarone-induced thyrotoxicosis （AIT） in patients. Methods： 32 cases of documented AIT were reviewed in our hospital, and the characteristics, therapeutic methods, laboratory parameters, and events during long-term follow-up were evaluated. The predefined end point consisted of the following AIT-associated complications： death, hospitalization for heart failure, stroke, arrhythmia management, and so on. Results： 32 cases were included in the present analysis, and 11 patients were treated with prednisone for AIT. There was no time difference in recovery of free thyroxine beween those treated and those not treated with prednisone. The result of long-term follow-up showed that there were high morbidity and mortality in patients treated with prednisone and the outcome was worse than those no treated with prednisone. Conclusion： Patients with AIT have a high event rate during follow-up. Prednisone had no effect on time in recovery of thyroxine levels. On the contrary, it augmented harmful event rate.