JCEM:接受甲状腺切除术的甲状腺癌患者心血管结局

2021-08-09 MedSci原创 MedSci原创

DTC患者发生房颤、CVD、心率加快和左心室质量增重的风险增加。

在一般人群中,甲状腺功能障碍与血管疾病(CVD)风险增加有关;然而,分化型甲状腺癌(DTC)治疗,包括甲状腺切除术和注射促甲状腺激素抑制,是否会进一步增加CVD风险仍存在争议。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在评估DTC患者的CVD风险。

研究人员对MEDLINE、EMBASE和Web of Science进行了检索,并对评估DTC与心血管结局之间关联的观察性研究进行了回顾。研究人员排除了在DTC诊断前将CVD评估为合并症的研究,以及那些使用主动监测而不用甲状腺切除术作为干预的研究。当三项或更多研究报告了感兴趣的结局时,研究人员使用随机和固定效应模型对合并风险进行估计。研究人员评估了超声心动图和血液动力学参数。

该定量分析中包括18项研究(193320例DTC患者和225575例健康对照者)。DTC与房颤(合并风险比[RR]=1.55[95%置信区间:1.30-1.84])、冠状动脉疾病(RR=1.10[1.00-1.21])、脑血管意外(RR=1.15[1.09-1.20])和全因死亡率(RR=1.95[1.03-3.69])风险增加相关。DTC与较高的舒张压(标准化平均差[S​​MD]为0.22[0.01-0.42])、心率(0.37[0.17-0.57])、左心室质量指数(0.66[0.45-0.88])和室间室间隔厚度(0.91[0.33-1.49])和早期至晚期心室充盈速度降低(-0.42[-0.79-(-0.05)])相关,但与射血分数无关。

由此可见,DTC患者发生房颤、CVD、心率加快和左心室质量增重的风险增加。

原始出处:

Eun Kyung Lee.et al.Cardiovascular outcomes in thyroid cancer patients treated with thyroidectomy: A meta-analysis.JCEM.2021.https://doi.org/10.1210/clinem/dgab576

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    2022-01-09 smallant2015
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    2022-01-20 achengzhao
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1778097, encodeId=18001e78097c9, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Sun Jan 09 04:36:59 CST 2022, time=2022-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063479, encodeId=cd4f20634e9f8, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Thu Jan 20 05:36:59 CST 2022, time=2022-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877460, encodeId=703118e7460fa, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Jul 04 16:36:59 CST 2022, time=2022-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269387, encodeId=bc1a126938e9c, content=<a href='/topic/show?id=49d1518915a' target=_blank style='color:#2F92EE;'>#心血管结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51891, encryptionId=49d1518915a, topicName=心血管结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Wed Aug 11 13:36:59 CST 2021, time=2021-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1006622, encodeId=c17b10066220f, content=这是个令人担心的问题!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=328e1571410, createdName=liuzhengrong618, createdTime=Tue Aug 10 13:38:34 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1006602, encodeId=5df31006602d1, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210718/00c6135c486d494ba3a6de6564321e4b/210f794fc7764c1fbd33f29779f68f37.jpg, createdBy=2ce95551880, createdName=牧师与屠夫, createdTime=Tue Aug 10 12:23:39 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1006548, encodeId=41e01006548ff, content=学习一下~, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Tue Aug 10 08:18:27 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1006518, encodeId=ef881006518b9, content=清楚!<a href='/topic/show?id=974e51e2810' target=_blank style='color:#2F92EE;'>#心血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51728, encryptionId=974e51e2810, topicName=心血管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=98565568683, createdName=ms6000001174205321, createdTime=Mon Aug 09 23:51:46 CST 2021, time=2021-08-09, status=1, ipAttribution=)]
    2021-08-10 liuzhengrong618

    这是个令人担心的问题!

    0

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    2021-08-10 牧师与屠夫

    学习了

    0

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    2021-08-10 学医无涯

    学习一下~

    0

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    2021-08-09 ms6000001174205321

    清楚!#心血管#

    0

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