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【JCEM】左旋甲状腺素治疗年轻人先天性甲减的长
http://jcem.endojournals.org/cgi/content/short/jc.2007-2315v1
Context: Congenital hypothyroidism (CH) is the most prevalent endocrine disorder in the newborn and is routinely treated with life-long levothyroxine replacement therapy. Although several studies have demonstrated that such therapy may impact on the cardiovascular system, little is known with regard to the effects of long-term levothyroxine administration in patients with congenital hypothyroidism.
Objective: The aim of the current study was to evaluate whether long-term L-T4 replacement therapy in young adults with CH is associated with cardiovascular abnormalities.
Patients and methods: Thirty young adults with congenital hypothyroidism aged 18.1±0.2 years and 30 age and sex-matched controls underwent cardiac and carotid Doppler ultrasound and symptom-limited cardiopulmonary exercise testing. Hypothyroidism was diagnosed by neonatal screening and levothyroxine treatment was initiated within the first month of life and carefully adjusted to maintain TSH levels in the normal range and free thyroxine in the high-normal range.
Results: Compared with controls, hypothyroid patients exhibited left ventricular (LV) diastolic dysfunction, impaired exercise capacity, and increased intima-media thickness. At multiple regression analysis, the number of episodes of plasma TSH levels <0.5 mU/l and >4.0 mU/l from the age of 1 year onward and mean TSH plasma levels during puberty were independent predictors of diastolic filling and cardiopulmonary performance indexes (multiple r values: 0.61-0.75).
Conclusions: Long-term levothyroxine treatment in young adults with congenital hypothyroidism is associated with impaired diastolic function and exercise capacity, and increased intima-media thickness. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领
长期应用左旋甲状腺素治疗年轻人先天性甲状腺功能减退对心血管的影响
Context: Congenital hypothyroidism (CH) is the most prevalent endocrine disorder in the newborn and is routinely treated with life-long levothyroxine replacement therapy. Although several studies have demonstrated that such therapy may impact on the cardiovascular system, little is known with regard to the effects of long-term levothyroxine administration in patients with congenital hypothyroidism.
研究内容：先天性甲状腺功能减退症是新生儿中最常见的内分泌紊乱性疾病，常常需终生采用左旋甲状腺素替代疗法来治疗。尽管好几项研究已经证实此种疗法可能影响心血管系统，人们对长期服用左旋甲状腺素治疗先天性甲状腺功能减退的影响知之甚好。
Objective: The aim of the current study was to evaluate whether long-term L-T4 replacement therapy in young adults with CH is associated with cardiovascular abnormalities.
研究目的：此项研究的目的是评估长期采用左旋甲状腺素替代疗法治疗年轻人先天性甲状腺功能减退是否与心血管功能异常有关。
Patients and methods: Thirty young adults with congenital hypothyroidism aged 18.1±0.2 years and 30 age and sex-matched controls 编译
长期应用左旋甲状腺素治疗年轻人先天性甲状腺功能减退对心血管的影响
研究内容：先天性甲状腺功能减退症是新生儿中最常见的内分泌紊乱性疾病，常常需终生采用左旋甲状腺素替代疗法来治疗。尽管好几项研究已经证实此种疗法可能影响心血管系统，人们对长期服用左旋甲状腺素治疗先天性甲状腺功能减退的影响知之甚好。
研究目的：此项研究的目的是评估长期采用左旋甲状腺素替代疗法治疗年轻人先天性甲状腺功能减退是否与心血管功能异常有关。
研究对象和研究方法：30名患有先天性甲状腺功能减退症的年轻人的年龄为18.1±0.2岁，对这三十名患者进行年龄和性别匹配控制，他们接受心脏和颈部动脉多普勒超声检查以及症状限制性心肺运动试验。通过新生儿疾病筛查诊断甲状腺功能减退症，在新生儿出生后的第一个月开始应用左旋甲状腺素并且仔细调整以维持促甲状腺素水平在正常范围之内，游离甲状腺素水平高于正常范围。
研究结果：与控制组患者相比，对照组的患者显示左心室舒张功能障碍、运动功能受损以及内膜中层厚度增加。通过多元回归分析发现，血浆促甲状腺水平<0.5 mU/l，一岁以后>4.0 mU/l，青春期平均血浆促甲状腺水平是舒张期充盈和心肺功能指数的独立预测因素。
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作者:admin@医学,生命科学 2011-10-14 05:20
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