胺碘酮与甲状腺幻灯片.pptVIP

胺碘酮和甲状腺 The American Journal of Medicine 2005; 118: 706-714 Amiodarone is a potent anti-arrhythmic drug used for the prophylaxis and treatment of cardiac arrhythmias. Although highly effective in patients with arrhythmias, its use is associated with a wide array of adverse effects The cornea, lungs, liver, skin, and the thyroid are the major organs affected 胺碘酮的结构与T3和T4相似，每分子的胺碘酮含两个碘原子，占其质量的37.5% 服用200mg/天的胺碘酮相当于每天摄入75mg有机碘。胺碘酮脱碘后每天释放6mg游离碘，比日常摄入量0.15-0.30 mg高20～40倍 胺碘酮半衰期长，约100天，主要因为胺碘酮在脂肪组织沉积。因此多余的碘经数月才能逐渐清除，有时候胺碘酮毒性作用甚至发生在停药后 胺碘酮对多个器官如皮肤、角膜等的损害，主要是因为药物在间质的沉积 可能有两种机制参与了胺碘酮对甲状腺功能的影响。一是大剂量的碘负荷