短疗程抗甲状腺药物治疗112例Graves病的观察

Observation of the Outcome of 112 Cases with Graves, Disease Treated by Short-Term Antithyroid Drug Therapy for One Year

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摘要作者用他巴唑短疗程(6个月)治疗112例弥漫性甲状腺肿伴甲状腺机能亢进症(Graves病)的初发患者,停药后1年的缓解率为41.4％,比文献中报道治疗1年以上的平均缓解率(46.7％)稍低。作者通过一些临床特征及生化指标与复发或缓解的关系分析认为,Graves病患者并不都要按惯例长期服药。对那些治疗前血清T_3水平不是太高、治疗中甲状腺缩小明显、血管杂音消失以及治疗数月后,甲状腺吸碘率能被外源性甲状腺激素所抑制的新病例,用短程治疗可能获得良好预后。 One hundred and twelve new cases withGraves' disease were treated by tapazolefor 6 months and followed-up for another12 months in a prospective study.One hun-dred and eleven cases completed the wholecourse of study. and only one failed to befollowed up. The results of the follow-upfor l2 mon showed that the remission ratewas 41.4g (46/111) and relapse rate was58.6% (65/111). The present study indicatedthat the remission or relapse was relatedwih serum levels of T_3, before treatment,shrinked goiter and disappearance of goiterbruit during the treatment as well as thyroidsuppression rate, but not related to sex,age, period of illness before therapy or se-verity of the disease. It is suggested that a6-mon antithyroid drug therapy instead oftraditional 1ong term therapy may besuitable for those patients who are with a re-duced goiter and disappeared goiter bruitduring the antithyroid therapy, and suppres-sible thyroid up-take by T_3, or thyroideumand whose serum levels of T_3, before treat-ment are not very high. So the patientsmay benefit from the short-term therapy.They are not only able to obtain a pro-longed remission but also save time andmoney.