钱心雨,李婷婷

甲状腺功能减退症（甲减）在我国成年人群中患病率较高，其中亚临床甲减占比显著，临床防治需求迫切。优甲乐（左甲状腺素钠片）作为甲减一线替代治疗药物，其疗效与时效特性已得到多项研究证实：短期治疗可显著改善血清促甲状腺激素（TSH）及游离甲状腺素（FT4）水平，长期规律治疗能有效提升甲状腺功能指标达标率，并改善患者生活质量。在此基础上，中西医结合治疗（如联合疏肝健脾消瘿汤等）可进一步缩短TSH达标时间，减少优甲乐用量；新型治疗策略如纳米递送系统、药物基因组学指导的精准用药等，也展现出缩短治疗周期、优化疗效的潜力。国内外指南强调，基于优甲乐的半衰期特征，临床需定期监测并调整剂量，对TSH显著升高者应及时启动治疗，以降低并发症风险。目前研究仍面临个体化疗效预测不足等挑战，未来需结合多组学技术与人工智能，进一步优化优甲乐治疗方案，推动甲减治疗的精准化与个体化发展。

甲状腺功能减退症；优甲乐；左甲状腺素钠；时效特性；中西医结合；精准治疗；指南解读

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