摘要
目的探讨自身免疫性甲状腺疾病局部免疫调节治疗的有效性、安全性。方法采用糖皮质激素等药物对2002—2005年南京医科大学第一附属医院内分泌科确诊的110例自身免疫性甲状腺疾病患者进行甲状腺局部免疫调节治疗,依病例不同在甲状腺局部穿刺注射不同剂量糖皮质激素等药物,对其有效性、安全性等进行观察,并定期随访观察2～3年。结果甲状腺局部免疫调节治疗后,患者自觉症状明显改善,总有效率94.0%;甲状腺功能好转或恢复者67.7%;甲状腺肿明显减小者92.0%;治疗前后甲状腺自身抗体和过氧化物酶抗体下降,分别为(338.2±43.2)mU/L和(266.9±42.2)mU/L(P<0.01)。治疗中并发症及副反应少见。结论甲状腺局部免疫调节治疗具有疗效佳、操作简便、创伤性小且并发症少等特点。选择适当的手术适应证、确定合适的治疗方案以及正确的操作方法是治疗成功的基础;精心的术前术后护理以及良好的心理疏导,则是治疗成功的重要环节。
Objective To investigate the efficacy and safety of local immune regulation therapy of thyroid disease. Methods Totally 110 patients with confirmed diagnosis of autoimmune thyroid disease were recruited. All patients received thyroid local immune regulation therapy with glucocorticoids 1 - 3 courses of treatment and followed up for 2 - 3 years, each being taken good care of during the whole observation. Results About 94. 0% of the patients had significantly improved their subjective symptoms, such as pain, fatigue, and lethargy. About 67.7% of the cases had reached normal or markedly improved thyroid function after thyroid local immune regulation therapy. About 92.0% of the volumes of thyroid were reduced. Serum antithyroperoxldase antibody levels were decreased from （ 338. 2 ± 43. 2 ） mU/L to （ 266. 9 ± 42. 2 ） mU/L（ P 〈 0. 01 ）. Subjective symptoms such as pain, fatigue, and lethargy had been significantly improved. Only a few side effects or complications of therapy were observed during the treatment. Conclusion Local immune regulation therapy with glucocorcoid is a cost-effective, safe and easy-to-do treatment procedure for the patients with autoimmune thyroid disease. The keys to the successful treatment of thyroid local immune regulation therapy are appropriate indications, suitable therapeutic regimens and correct operation procedures. Elaborative nursing care and mental nursing also play essential roles in the treatment.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2008年第1期32-35,共4页
Chinese Journal of Practical Internal Medicine
基金
江苏省社会发展基金(BS200403P)
关键词
甲状腺疾病
局部免疫调节
治疗
糖皮质激素
thyroid disease
local immune regulation therapy
treatment
glueocortieoids
