引起甲状腺功能异常的常见药物对血清生物标志物检测的影响

Common drugs that cause abnormalities in the thyroid gland functions and their impact on levels of serum biomarkers

药物治疗过程中出现的甲状腺功能指标的异常已经受到人们日益的关注,包括传统的药物,例如:糖皮质激素、非甾体类抗炎药、碘剂等,也包括新型药物如免疫检查点抑制剂等。甲状腺功能指标的异常可源于药源性甲状腺疾病、药物相互作用影响外源性甲状腺素治疗,也可源于药物对体外检测的干扰。本文重点阐述了几种药物在甲状腺激素调节、合成与释放、转运和代谢等多环节中的影响及其作用机制,同时简要介绍了影响外源性甲状腺激素治疗,以及干扰甲状腺功能检测的部分药物及其作用机制,以期加强人们对药源性甲状腺疾病的了解,并对药物引起的体外检测干扰有所警惕。

The abnormal thyroid function in the duration of drug treatment has attracted increasing attention,these drugs included traditional drugs,such as glucocorticoid,nonsteroidal anti-inflammatory drug,iodine agent,etc.;also included new types of drugs,such as immune checkpoint inhibitors.The possible reasons causing abnormality of thyroid biomarkers included drugs′toxicity on thyroid,drug-drug interaction affecting synthetic thyroid hormones therapy,and drug′s interference on biomarkers′measurement.This article focused on the influence and mechanisms of common drugs on the regulation,synthesis,release,transport and metabolism of thyroid hormones.Here also briefly introduced the mechanism of drug-drugs interaction on the effect of synthetic thyroid hormone;the interference and mechanism of some drugs on the laboratory measurement was also included.The aim of this article was to strengthen clinician′s understanding on drug-induced thyroid diseases and to be alert to drugs′interference on the in-vitro measurement of biomarkers.