Thyroid Hormone Suppression Therapy
Thyroid Hormone Suppression Therapy
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DOI：
10.1016/j.ecl.2018.10.008
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发表时间：
2019-03-01
影响因子：
4.5
通讯作者：
Cooper, David S.
中科院分区：
文献类型：
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作者：
Biondi, Bernadette;Cooper, David S.
甲状腺激素抑制疗法是为了降低血清促甲状腺激素（TSH）水平而设计的，使用的甲状腺激素剂量超过正常情况下维持甲状腺正常状态所需的剂量。这种疗法的基础是认识到TSH是甲状腺癌的生长因子，因此较低的血清TSH水平可能与疾病活动性降低有关。然而，临床研究并没有记录抑制TSH的改善结果，除了最晚期的患者。此外，积极的甲状腺激素治疗有许多负面结果，包括骨质疏松、骨折和心血管疾病。因此，美国甲状腺协会建议基于初始风险和持续风险评估，采用分级方法抑制TSH。
Thyroid hormone suppression therapy is designed to lower serum thyrotropin (TSH) levels using doses of thyroid hormone in excess of normally be required to maintain a euthyroid state. The basis of this therapy is the knowledge that TSH is a growth factor for thyroid cancer, so that lower serum TSH levels might be associated with decreased disease activity. However, clinical studies have not documented improved outcomes with TSH suppression, except in patients with the most advanced disease. Furthermore, there are a number of negative outcomes related to aggressive thyroid hormone therapy, including osteoporosis, fracture, and cardiovascular disease. Therefore, a graded approach to TSH suppression is recommended by the American Thyroid Association, based on initial risk and ongoing risk assessment.