罗沙司他导致低促甲状腺激素性甲状腺功能减退一例  

A Case Report of Hypothyrotropin Hypothyroidism Caused by Roxadustat

作　　者：闫雪莲[1] 唐冰颖 曲璇 张宁 康琳 YAN Xuelian;TANG Bingying;QU Xuan;ZHANG Ning;KANG Lin(Department of Pharmacy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Pharmacy,Yantai Yuhuangding Hospital,Yantai,Shandong 264009,China;Department of Geriatrics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院药剂科,北京100730 [2]烟台毓璜顶医院药学部,山东烟台264009 [3]中国医学科学院北京协和医院老年医学科,北京100730

出　　处：《协和医学杂志》2025年第2期519-522,共4页Medical Journal of Peking Union Medical College Hospital

基　　金：中央高水平医院临床科研专项(2022-PUMCH-B-129)。

摘　　要：罗沙司他是全球首个小分子低氧诱导因子脯氨酰羟化酶抑制剂,其引起低促甲状腺激素性甲状腺功能减退的不良反应较为罕见,在多病共存的老年患者中表现隐匿。本文报道1例肾性贫血老年患者,在服用罗沙司他12 d后出现可逆性低促甲状腺激素性甲状腺功能减退,甲状腺激素水平明显下降,停用罗沙司他后15 d,甲状腺激素水平逐渐恢复。后因肾性贫血加重再次服用罗沙司他,9 d后复查甲状腺功能相关指标下降,遂给予左甲状腺素替代治疗。本文结合相关文献对老年慢性肾脏病患者口服罗沙司他过程中发生的不良反应进行分析,旨在为此类患者的药物治疗提供参考。Roxadustat is the world's first small molecule hypoxia⁃inducible factor prolyl hydroxylase in⁃hibitor.Its adverse effect of causing hypothyroidism with low thyroid⁃stimulating hormone(TSH)is relatively rare and manifests subtly in elderly patients with multiple coexisting diseases.This article reports a case of an elderly patient with renal anemia who developed reversible low⁃TSH hypothyroidism after taking roxadustat for 12 days,with a significant decrease in thyroid hormone levels.After discontinuing roxadustat for 15 days,the thyroid hormone levels gradually returned to normal.Due to the worsening of renal anemia,the patient took rox⁃adustat again,and 9 days later,the thyroid function⁃related indicators decreased upon re⁃examination,leading to the initiation of levothyroxine replacement therapy.In conjunction with relevant literature,this article analyzes the adverse reactions that occur during the oral administration of roxadustat in elderly patients with chronic kidney disease,aiming to provide reference for drug treatment of such patients.

关 键 词：罗沙司他 缺氧诱导因子脯氨酸羟化酶抑制剂 低促甲状腺激素性甲状腺功能减退 

分 类 号：R581.2[医药卫生—内分泌] R973.3[医药卫生—内科学]