Thyroid abnormalities in lithium-treated patients
Thyroid abnormalities in lithium-treated patients
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DOI：
10.1007/bf02848693
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发表时间：
2002-07-01
影响因子：
3.8
通讯作者：
Kulan, E
中科院分区：
文献类型：
--
作者：
Ozpoyraz, N;Tamam, L;Kulan, E
本研究的目的是评估锂对甲状腺功能的可能影响，确定甲状腺功能、抗体水平和人口/临床变量之间的关系，并确定锂相关甲状腺肿、临床甲状腺功能减退症和甲状腺抗体的患病率。纳入了 49 名服用锂剂至少 6 个月的患者，以及 46 名年龄和性别匹配的从未使用过锂剂的对照者。抽取血液来测量总 T3、T4、促甲状腺激素 (TSH) 以及抗微粒体和抗甲状腺球蛋白抗体的水平。通过超声检查量化甲状腺体积。研究组中有 29 名患者（59%）和对照组有 7 名患者（15%）患有甲状腺肿。研究组中游离 T4 水平显着较低，而 TSH 水平较高。在接受锂治疗的患者中，12% 患有临床甲状腺功能减退症，2% 患有亚临床甲状腺功能减退症。锂盐组中有 23% 存在甲状腺抗体，对照组有 15%。甲状腺抗体、甲状腺体积和临床甲状腺功能减退症之间没有明显的关系。我们的研究结果表明，除了致甲状腺肿效应之外，锂还会抑制甲状腺功能并导致临床甲状腺功能减退症。在本研究中，年龄较大、甲状腺疾病家族史和甲状腺抗体的存在显着影响甲状腺功能。
The purposes of this study were to evaluate possible effects of lithium on thyroid function, determine the relationship among thyroid function, antibody levels, and demographic/clinical variables, and establish the prevalence of lithium-related goiter, clinical hypothyroidism, and thyroid antibodies. Forty-nine patients who had taken lithium for a minimum of 6 months were enrolled, as were 46 age- and sex-matched controls naive to lithium use. Blood was drawn to measure levels of total and free T3, T4, thyroid-stimulating hormone (TSH), and antimicrosomal and antithyroglobulin antibodies.' Thyroid volume was quantified on ultrasonography. Twenty-nine patients in the study group (59%) and 7 in the control group (15%) had goiter. Free T4 levels were significantly lower in the study group, and TSH levels were higher. Among lithium-treated patients, 12% had clinical hypothyroidism and 2% had subclinical hypothyroidism. Thyroid antibodies were present in 23% of the lithium group and 15% of the control group. No significant relationship was apparent among thyroid antibodies, thyroid volume, and clinical hypothyroidism. Our findings suggested that along with its goitrogenic effects, lithium inhibited thyroid function and led to clinical hypothyroidism. Older age, family history of thyroid disorders, and the presence of thyroid antibodies significantly influenced thyroid function in the present study.