68例服胺碘酮的75岁以上老年心律失常患者甲功变化分析

目的：探讨口服小剂量胺碘酮对老年心律失常患者甲状腺功能的作用和影响。方法：回顾性分析老年器质性心脏病心律失常患者68例，记录胺碘酮治疗方案与疗效、甲状腺变化及随访干预措施情况。结果：老年人服用胺碘酮引起甲状腺疾病发生率为31．8％（22／68），以甲状腺功能减退25．7％（18／68）为主，大致为甲状腺功能亢进（6．1％，4／68）的4倍。采用小剂量胺碘酮方案出现的甲状腺功能紊乱多数经过减量或停药逆转或恢复。结论：老年人服用胺碘酮甲状腺功能紊乱发生率高，但临床表现不典型，应更密切地监测甲状腺功能；甲状腺功能紊乱经胺碘酮及时减量或停药等措施多能逆转或恢复。

Effect of Amiodarone on Thyroid Functions in Elder Patients with Arrhythmia

Objective： To investigate the effect of small dose ofamiodarone on thyroid functions in elderly patients with arrhythmia. Method： Clinical data of sixty-eight arrhythmia cases in patients with organic heart disease aged 75 years or older were retrospectively reviewed, including treatment scheme and effect of amiodarone, changes of thyroid function between before and 1, 3 and 6 months after treatment, and intervention measures. Result： The incidence of thyroid diseases was 31.8% （22/68）, including 25,7 % （18/68） hypothy- roidism and 6.1% （4/68） hyperthyroidism in the elderly patients treated with amiodarone. The dysfunction of thyroid mostly can be re- versed or recovered after drug reduction or discontinuance. Conclusion： After amiodarone treatment, the incidence of thyroid dysfunction was high in elderly arrhythmia patients with organic heart disease, but clinical symptoms were not typical, so it is necessary to closely monitor their thyroid fimctions. The thyroid dysfunction mostly can be reversed or recovered after appropriate drug reduction or discontinuance in intensive follow-up.