根据甲状腺组织容积管理接受左甲状腺素单药治疗的患者的甲状腺激素测量项目现状。

IF 1.3 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Endocrine journal Pub Date : 2024-10-23 DOI:10.1507/endocrj.EJ24-0259
Mitsuru Ito, Hanna Deguchi-Horiuchi, Sawako Takahashi, Mako Hisakado, Kazuyoshi Kohsaka, Eijun Nishihara, Shuji Fukata, Mitsushige Nishikawa, Akira Miyauchi, Takashi Akamizu
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引用次数: 0

摘要

我们和其他研究人员报告说,甲亢患者需要用左甲状腺素(LT4)轻度抑制促甲状腺激素,以达到正常的游离三碘甲状腺原氨酸(FT3)水平和甲状腺代谢正常状态。因此,隈研吾医院对接受LT4治疗的患者实施了基于甲状腺组织容量的管理方法。这项回顾性研究考察了接受LT4单药治疗的患者的甲状腺激素测量项目(血清游离甲状腺素[FT4]、FT3和FT4+FT3)的构成。根据甲状腺功能减退症的病因,本研究纳入的 25523 名患者中有 36% 接受了甲状腺全切除术(TT)。13%和14%的患者分别接受了131I治疗甲状腺功能亢进症(RIT)和甲状腺部分切除术(PT)。此外,37%的患者接受过无创治疗(NIT)。在前两组中,只进行 FT3 测量的患者比例较高(TT,93%;RIT,61%),而在其余两组中,只进行 FT4 测量的患者比例较高(PT,50%;NIT,65%)。58%的患者只进行了 FT3 测量。34%的患者只进行了 FT4 测量。近半数患者(46%)的血清促甲状腺激素水平受到抑制。因此,在接受LT4治疗的患者中,FT3是主要的甲状腺激素测定指标,而近一半患者的血清促甲状腺激素水平受到抑制。这可能是由于我们医院作为甲状腺疾病专科医院的管理指南所致,因为在接受TT或RIT治疗后,半数患者为无甲状腺或甲状腺萎缩。
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Current status of the thyroid hormone measurement items in patients receiving levothyroxine monotherapy by the management based on the thyroid tissue volume.

We and other investigators reported that mild TSH suppression with levothyroxine (LT4) was needed to achieve normal free triiodothyronine (FT3) levels and metabolic euthyroid state in athyreotic patients. Consequently, management methods based on thyroid tissue volume have been implemented for patients receiving LT4 at the Kuma Hospital. This retrospective study examined the composition of the thyroid hormone measurement items (serum-free thyroxine [FT4], FT3, and FT4 + FT3) in patients receiving LT4 monotherapy. According to the etiology of hypothyroidism, 36% of the 25,523 patients included in this study underwent total thyroidectomy (TT). Thirteen percent and 14% had undergone 131I treatment for hyperthyroidism (RIT) and partial thyroidectomy (PT), respectively. Moreover, 37% of patients had received non-invasive treatment (NIT). The proportion of patients who underwent only FT3 measurements was higher (TT, 93%; RIT, 61%) in the first two groups, whereas the proportion of patients who underwent only FT4 measurements was higher (PT, 50%; NIT, 65%) in the remaining two groups. Only FT3 measurements were performed in 58% of patients. Only FT4 measurements were performed in 34% of patients. The serum TSH levels were suppressed in nearly half of the patients (46%). Thus, FT3 was the major thyroid hormone measured in patients receiving LT4 treatment, and the serum TSH levels were suppressed in nearly half of the patients. This may be attributed to the management guidelines at our hospital, a specialized facility for thyroid disease, wherein half of the patients present are athyreotic or have atrophic thyroid glands after TT or RIT.

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来源期刊
Endocrine journal
Endocrine journal 医学-内分泌学与代谢
CiteScore
4.30
自引率
5.00%
发文量
224
审稿时长
1.5 months
期刊介绍: Endocrine Journal is an open access, peer-reviewed online journal with a long history. This journal publishes peer-reviewed research articles in multifaceted fields of basic, translational and clinical endocrinology. Endocrine Journal provides a chance to exchange your ideas, concepts and scientific observations in any area of recent endocrinology. Manuscripts may be submitted as Original Articles, Notes, Rapid Communications or Review Articles. We have a rapid reviewing and editorial decision system and pay a special attention to our quick, truly scientific and frequently-citable publication. Please go through the link for author guideline.
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