Kombinirovannoe primenenie levotiroksina i triyodtironina pri sindrome gipotireoza
- Authors: Pozdnyak A.O1, Lukin A.M1
-
Affiliations:
- Казанская государственная медицинская академия
- Issue: Vol 8, No 9 (2006)
- Pages: 102-104
- Section: Articles
- URL: https://ogarev-online.ru/2075-1753/article/view/92299
- ID: 92299
Cite item
Full Text
Abstract
В последние годы существенно возрос интерес к применению как стандартных комбинированных препаратов тиреоидных гормонов, так и индивидуальных схем лечения левотироксином и трийодтиронином. Основным "официальным" показанием к назначению комбинированных препаратов тиреоидных гормонов является нарушение периферической конверсии Т4 в Т3. Подобные ситуации в клинической практике встречаются довольно часто.Рациональное назначение комбинированных препаратов тиреоидных гормонов (как стандартных, так и индивидуально подобранных доз) при синдроме гипотиреоза определенным категориям пациентов (в первую очередь молодого и среднего возраста без проявлений сердечно-сосудистой патологии) является оправданным вследствие более быстрой компенсации гипотиреоза (клинической и лабораторной), повышения работоспособности, активизации интеллектуальной активности, что приводит к улучшению качества жизни больных.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
A. O Pozdnyak
Казанская государственная медицинская академия
A. M Lukin
Казанская государственная медицинская академия
References
- Anselmo J, Refetoff S. Regression of a large goiter in a patient with resistance to thyroid hormone by every other day treatment with triiodothyronine. Thyroid 2004; 14 (1): 71–4.
- Brennan M.D, Bahn R.S. Thyroid hormones and illness. Endocr Pract 1998; 4 (6): 396–403.
- Bunevicius R, Kazanavicius G, Zalinkevicius R et al. Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med 1999; 340 (6): 424–9.
- Bunevicius R, Prange A.J. Mental improvement after replacement therapy with thyroxine plus triiodothyronine: relationship to cause of hypothyroidism. Int J Neuropsychopharmacol 2000; 4 (2): 167–74.
- Bunevicius R, Jakubonien N, Jurkevicius R et al. Thyroxine vs thyroxine plus triiodothyronine in treatment of hypothyroidism after thyroidectomy for Graves’ disease. Endocrine 2002; 18 (2): 129–33.
- Carrel T, Eckstein F, Englberger L et al. Thyronin treatment in adult and pediatric heart surgery: clinical experience and review of the literature. Eur J Heart Fail 2002; 4 (5): 577–82.
- Cassio A, Cacciari E, Cicognani A et al.Treatment for congenital hypothyroidism: thyroxine alone or thyroxine plus triiodothyronine? Pediatrics 2003; 111 (5): 1055–60.
- Ceremuzynski L, Gorecki A, Czerwosz L et al.Low serum triiodothyronine in acute myocardial infarction indicates major heart injury. Kardiol Pol 2004; 60 (5): 468–80.
- Chopra I.J. Clinical review 86: euthyroid sick syndrome: is it a misnomer? J Clin Endocrinol Metab 1997; 82 (2): 329–34.
- Chopra I.J. Nonthyroidal illness syndrome or euthyroid sick syndrome? Endocr Pract 1996; 2 (1): 45–52.
- Clyde P.W, Harari A.E, Getka E.J, Shakir K.M. Combined levothyroxine plus liothyronine compared with levothyroxine alone in primary hypothyroidism: a randomized controlled trial. JAMA 2003; 290 (22): 2952–8.
- Danzi S, Klein I. Thyroid hormone and the cardiovascular system. Minerva Endocrinol 2004; 29 (3): 139–50.
- Escobar-Morreale H.F, del Rey F.E, Obregon M.J, de Escobar G.M. Only the combined treatment with thyroxine and triiodothyronine ensures euthyroidism in all tissues of the thyroidectomized rat. Endocrinology 1996; 137 (6): 2490–502.
- Escobar-Morreale H.F, Obregon M.J, Escobar F et al. Morreale de Escobar Replacement therapy for hypothyroidism with thyroxine alone does not ensure euthyroidism in all tissues, as studies in thyroidectomized rats. J Clin Invest 1995; 96 (6): 2828–38.
- Hennemann G, Docter R, Visser T.J et al. Thyroxine plus low - dose, slow - release triiodothyronine replacement in hypothyroidism: proof of principle. Thyroid 2004; 14 (4): 271–5.
- Hueston W.J. Treatment of hypothyroidism. Am Fam Physician 2001; 64 (10): 1717–24.
- Kanavin O.J, Aaseth J, Birketvedt G.S. Thyroid hypofunction in Down’s syndrome: is it related to oxidative stress? Biol Trace Elem Res 2000; 78 (1–3): 35–42.
- Kvicala J, Zamrazil V. Effect of iodine and selenium upon thyroid function. Cent Eur J Public Health 2003; 11 (2): 107–13.
- Mocchegiani E, Giacconi R, Cipriano C et al. Metallothioneins (I+II) and thyroid - thymus axis efficiency in old mice: role of corticosterone and zinc supply. Mech Ageing Dev 2002; 123 (6): 675–94.
- Sawka A.M, Gerstein H.C, Marriott M.J et al. Does a combination regimen of thyroxine (T4) and 3,5,3’-triiodothyronine improve depressive symptoms better than T4 alone in patients with hypothyroidism? Results of a double - blind, randomized, controlled trial. J Clin Endocrinol Metab 2003; 88 (10): 4551–5.
- Siegmund W, Spieker K, Weike A.I et al.Replacement therapy with levothyroxine plus triiodothyronine (bioavaliable molar ratio 14:1) is not superior to thyroxine alone to improve well - being and cognitive performance in hypothyroidism. Clin Endocrinol 2004; 60 (6): 750–7.
- Walsh J.P, Shiels L, Lim E.M et al.Combined thyroxine/liothyronine treatment does not improve well - being, quality of life, or cognitive function compared to thyroxine alone: a randomized controlled trial in patients with primary hypothyroidism. J Clin Endocrinol Metab 2003; 88 (10): 4543–50.
- Weissel M. Administration of thyroid hormones in therapy of psychiatric illnesses. Acta Med Austriaca 1999; 26 (4): 129–31.
- Wiersinga W.M. Thyroid hormone replacement therapy. Horm Res 2001; 56 (Suppl. 1): 74–81.
- Zimmermann M.B, Kohrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid 2002; 12 (10): 867–78.
Supplementary files
