PCI 后急性疼痛性甲状腺炎和甲状腺毒症--病例研究。

Pub Date : 2023-11-01 DOI:10.20471/acc.2023.62.03.18
Ena Kurtić, Ivica Premužić Meštrović, Matija Marković, Vinko Roso, Valentina Obadić, Mario Stipinović, Tomislav Letilović
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引用次数: 0

摘要

破坏性甲状腺炎是一种自限性疾病,其特点是甲状腺激素急性释放。我们介绍了一名在急性心肌梗死(无ST段抬高)经皮冠状动脉介入治疗(PCI)后出现的极其罕见的急性疼痛性甲状腺炎患者。急性发作的甲状腺疼痛、fT3、fT4和炎症指标的升高与急性破坏性甲状腺炎相符。这种急性甲状腺炎可能是由于在PCI过程中使用的碘化造影剂向患者输入了大量碘而诱发的局部炎症。由于越来越多的患者转诊接受心导管检查,有创心脏病专家应该意识到使用碘造影剂可能会导致严重的甲状腺功能障碍。我们本文的目的是根据患者的情况,讨论PCI术后甲状腺功能障碍患者的病理生理学、临床表现、治疗和潜在的预防措施。
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ACUTE PAINFUL THYROIDITIS AND THYROTOXICOSIS AFTER PCI - A CASE STUDY.

Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous coronary intervention (PCI) in acute myocardial infarction without ST-elevation. The acute onset of thyroid pain and increase of fT3, fT4 and parameters of inflammation were compatible with acute destructive thyroiditis. Such acute thyroiditis probably resulted from local inflammation induced by a large amount of iodine given to the patient via iodinated contrast media used during PCI. Because of the increasing number of patients referred to cardiac catheterization, invasive cardiologists should be aware of the potentially serious thyroid dysfunction that can result from iodinated contrast use. The aim of our paper is, in the light of the patient presented, to discuss the pathophysiology, clinical presentations, therapy and potential preventive measures in patients that develop thyroid dysfunction after PCI.

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