打开APP

Arch Intern Med:碘化造影剂有可能损害甲状腺功能

  1. 含碘对比剂
  2. 甲亢

来源:生物谷 2012-11-18 10:49

在医学扫描和成像操作(如心导管术和CT扫描)中经常用到的碘化造影剂(ICM)一般是被当作药品来进行管理使用的。虽然目前,运用碘化造影剂所带来的特定并发症(如造影剂相关性肾病)已经展开了深入的研究,但很少有研究涉及到碘化造影剂对甲状腺功能影响这一问题。

在医学扫描和成像操作(如心导管术和CT扫描)中经常用到的碘化造影剂(ICM)一般是被当作药品来进行管理使用的。虽然目前,运用碘化造影剂所带来的特定并发症(如造影剂相关性肾病)已经展开了深入的研究,但很少有研究涉及到碘化造影剂对甲状腺功能影响这一问题。

1月23日,一项发表在Arch Intern Med杂志上的研究"Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism"证实:在拍片操作过程中碘化造影剂的使用,会影响甲状腺功能甚至会带来甲亢发病高风险。

该项研究的主要研究人员--布里格姆妇女医院肾病科的Connie M. Rhee医学博士等收集了自1990年1月至2010年6月之间来诊所就医的患者的相关数据(患者中不包括患有甲亢或甲状腺功能异常者)。科研人员将这些患者病例与甲状腺功能正常的人进行比较,结果发现在就医过程中使用碘化造影剂的患者,或多或少都存在甲状腺功能异常,有的甚至患上了甲亢。

在所有收集到的病例中,总共有178例患者因就医过程中使用了碘化造影剂而患上了甲亢,共有213例患者甲状腺功能出现异常。因此,作者认为碘化造影剂的使用与甲亢的发病有着密切联系,但研究数据并不能证明碘化造影剂的使用是否也会造成甲状腺功能异常。

总的来说,根据该项研究数据分析,碘化造影剂的使用是会增加患者甲亢疾病发生几率的。研究人员表示:在当代医学操作过程中,碘化造影剂的普遍使用所导致的甲状腺功能异常这一问题需要进行更多的研究,以明确碘化造影剂的使用与甲状腺功能异常之间的因果关系。(生物谷Bioon.com)

Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Connie M. Rhee, MD; Ishir Bhan, MD, MPH; Erik K. Alexander, MD; Steven M. Brunelli, MD, MSCE

Background  Sudden exposure to high iodide levels may cause thyroid dysfunction. Despite compelling biological plausibility and clinical implication, the association between iodinated contrast media exposure and incident hyperthyroidism and hypothyroidism has not been rigorously studied.

Methods  We performed a nested case-control study of patients treated between January 1, 1990, and June 30, 2010, who did not have preexisting hyperthyroidism or hypothyroidism. In parallel analyses, incident hyperthyroid or hypothyroid cases were defined by a change in thyrotropin level from normal (at baseline) to low or high (follow-up measurement). Euthyroid controls were selected using an incidence density sampling approach and were matched to cases on the basis of age, sex, race/ethnicity, estimated glomerular filtration rate, follow-up thyrotropin measurement date, and interval between baseline and the follow-up thyrotropin measurement date. Iodinated contrast media exposure was assessed using claims data for contrast-enhanced computed tomography or cardiac catheterization.

Results  In total, 178 and 213 incident hyperthyroid and hypothyroid cases, respectively, were matched to 655 and 779 euthyroid controls, respectively. Iodinated contrast media exposure was associated with incident hyperthyroidism (odds ratio [OR], 1.98; 95% CI, 1.08-3.60), but a statistically significant association with incident hypothyroidism was not observed (OR, 1.58; 95% CI, 0.95-2.62). In prespecified secondary analysis, iodinated contrast media exposure was associated with incident overt hyperthyroidism (follow-up thyrotropin level ≤0.1 mIU/L; OR, 2.50; 95% CI, 1.06-5.93) and with incident overt hypothyroidism (follow-up thyrotropin level >10 mIU/L; OR, 3.05; 95% CI, 1.07-8.72).

Conclusion  Iodinated contrast media exposure is associated with subsequent development of incident hyperthyroidism and incident overt hypothyroidism.

版权声明 本网站所有注明“来源:生物谷”或“来源:bioon”的文字、图片和音视频资料,版权均属于生物谷网站所有。非经授权,任何媒体、网站或个人不得转载,否则将追究法律责任。取得书面授权转载时,须注明“来源:生物谷”。其它来源的文章系转载文章,本网所有转载文章系出于传递更多信息之目的,转载内容不代表本站立场。不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。

87%用户都在用生物谷APP 随时阅读、评论、分享交流 请扫描二维码下载->