冠心病合并甲亢患者使用碘克沙醇1例并文献分析

A case study on the treatment of coronary heart disease combined with hyperthyroidism using iodixanol and literature analysis

为了探讨冠心病合并甲状腺功能亢进(甲亢)患者选用何种碘对比剂,本研究依据1例冠心病合并甲亢患者病情特点,临床药师检索及查阅文献,阐述碘对比剂对冠心病合并甲亢风险人群甲状腺功能影响及防治措施。冠心病合并甲亢患者行经皮冠状动脉介入术时优先选择第3代等渗非离子型对比剂如碘克沙醇,在碘对比剂前立即给予预防性治疗(甲巯咪唑片30 mg,po,qd,持续14 d)。临床中应关注碘对比剂对甲状腺功能影响,使用前需筛查高风险人群,并综合评估患者甲状腺疾病、心血管合并症、年龄等因素后,个体化给予药物预防。

In order to explore which iodine contrast agents should be used in patients with coronary heart disease complicated with hyperthyroidism.Based on the characteristics of a patient with coronary heart disease complicated with hyperthyroidism,this study described the effects of iodine-containing contrast agents on thyroid function in patients at risk of coronary heart disease complicated with hyperthyroidism and their preventive measures through clinical pharmacists'search and literature review.The third generation isotonic nonionic contrast agent such as ioxanol is preferred during percutaneous coronary intervention in patients with coronary heart disease and hyperthyroidism,and prophylactic treatment(thiamazole tablets,30 mg,po,qd,for 14 d)was given immediately before iodine-containing contrast agent.In clinical practice,attention should be paid to the impact of iodine-containing contrast agents on thyroid function.Before use,high-risk populations should be screened,and personalized medication should be given after comprehensive evaluation of factors such as thyroid disease,cardiovascular complications,and age in patients.