甲亢合并肝损害的临床合理用药

甲亢合并肝损害的临床合理用药
尹士男
【期刊名称】《药品评价》
【年(卷),期】2016(013)001
【摘要】甲状腺功能亢进合并肝损害在临床上比较常见，包括甲亢性肝损害、抗甲状腺药物致肝损害、合并自身免疫性肝病及病毒性肝炎等。

各种类型各有其临床特点，鉴别病因进而合理化用药是防治甲亢合并肝损害的关键。

甲亢性肝损害有赖于甲亢的及早控制。

抗甲状腺药物性肝损害多成良性经过，无论儿童或成人甲亢均首选MMI，仅在妊娠前3个月、严重甲亢或甲状腺危象、对MMI发生不良反应时使用PTU。

如肝损害已严重或严重肝病，推荐131I治疗。

%Hyperthyroidism is frequently combined with hepatic injury. Liver dysfunction in patients with hyperthyroidism includes abnormalities associated with the effects of thyroid hormone excess, those secondary to drug-induced liver injury, and changes resulting from concomitant liver disease. All types have different clinical characteristics, and pathogenic diagnosis is the key to the prevention and treatment. The therapeutic principle of the liver injury caused by hyperthyreosis is to relieve the hyperthyroidism.Hepatotoxicity induced by antithyroid drug is usually benign. MMI should be prescribed as the first-line agent in children or adults. Patients, who exhibited adverse reactions to previous MMI treatment or present severe thyrotoxicosis or thyroid storm, and women in the first trimester of pregnancy, are the only exceptions where PTU use might be accepted.131I treatment is
recommended when the liver damage has been serious or having severe liver disease.
【总页数】5页(P14-17,20)
【作者】尹士男
【作者单位】解放军总医院第一附属医院内分泌科，北京100037
【正文语种】中文
【中图分类】R581
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