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加碘盐和自身抗体对Graves病抗甲状腺药物治疗的影响 总被引:2,自引:0,他引:2
为探讨加碘盐 (AIS)饮食和甲状腺自身抗体对Graves病 (GD)病人抗甲状腺药物 (ATD)治疗的影响 ,我们对 2 76例GD病人进行了平均 5年追踪研究 ,报告如下。一、资料和方法表 1 AIS对GD病人ATD治疗的影响 ( x±s)组别例数 治疗前甲状腺重量 (g)首次缓解需时(d)1年复发率(% )5年复发率(% )维持ATD日用量(片 )缓解期FT3(ng/L)缓解期FT4 (ng/L)缓解期TSH(IU/L)缓解期TGAb阳性率(% )缓解期TPOAb阳性率(% )缓解期甲状腺重量 (g)NIS组 13 82 8.43± 45 .3 1± 1.45 3 7.681.68± 2 .43 … 相似文献
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目的 探讨Graves病患者使用不同抗甲状腺药物后再行131I治疗的疗效比较.方法 随访Graves病经抗甲状腺药物治疗后再行131I治疗的患者98例,按治疗前分别使用丙基硫氧嘧啶、他巴唑、碳酸锂分为3组,前两组在131I治疗前停用抗甲亢药物15天,碳酸锂组使用至治疗当日,采用个性化131I治疗后6个月复查并评价治疗效果.结果 使用丙基硫氧嘧啶组在131I治疗6月后仍有38%患者甲状腺功能亢进,使用他巴唑组甲亢比例为23%,而碳酸锂组仅为9.6%,3组间比较均有显著性差异(α<0.05);3组间发生甲减例数比较无显著性差异(P>0.05).结论 在131I治疗Graves病前使用丙基硫氧嘧啶会降低131I治疗甲亢的疗效,其影响高于他巴唑组及碳酸锂组,3组中碳酸锂组对131I治疗甲亢的疗效影响最小. 相似文献
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抗甲状腺药物治疗——Graves病治疗的首选 总被引:1,自引:0,他引:1
王曙 《中国实用内科杂志》2010,(1)
Graves病是甲亢中最常见的类型,是一种与自身抗体(TRAb)相关的自身免疫性疾病。其具体机制还不十分明确。Graves病治疗有抗甲状腺药物(ATD)、放射性碘(RAI)和手术3种传统的治疗方法。惟有ATD治疗是针对免疫因素,最终使TRAb转阴而治愈甲亢。中外文献反复强调ATD治疗是所有Graves甲亢的基础治疗,也是世界各地(除美国外)治疗甲亢的首选药物,其不破坏甲状腺滤泡结构,安全有效,药物作用可逆,不会造成永久性甲减。ATD治疗不仅能单选首选,还可作为手术和同位素治疗前的优选方案。美国ATA主席Cooper教授(NEJM,2005)提出了Graves甲亢的治疗路径可以给予我们一些临床指导。 相似文献
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选择本院在1998年1月~2008年7月内分泌科门诊和病房收治的既往有Graves病,服用抗甲状腺药物1年以上,停药10年的,以甲减就诊的病人16例。分析16例患者的临床资料,包括症状、体症、内分泌激素水平和治疗情况。研究其原因有:(1)自身免疫性甲状腺疾病的自然病程;(2)甲状腺细胞的凋亡,凋亡和抗凋亡分子在Graves患者中的不同作用,表现为甲状腺细胞的增生和亢进,与此相反,HT则表现为低下;(3)甲状腺素受体抗体(TRAb)中的阻断成分TSBAb可能是Graves病(GD)患者发生甲减的原因,TRAb不同组分的优势变化会引起甲状腺功能的波动。 相似文献
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目的探讨Graves病患者使用不同抗甲状腺药物后再行^131Ⅰ治疗的疗效比较。方法随访Graves病经抗甲状腺药物治疗后再行^131Ⅰ治疗的患者98例,按治疗前分别使用丙基硫氧嘧啶、他巴唑、碳酸锂分为3组,前两组在^131Ⅰ治疗前停用抗甲亢药物15天,碳酸锂组使用至治疗当日,采用个性化^131Ⅰ治疗后6个月复查并评价治疗效果。结果使用丙基硫氧嘧啶组在^131Ⅰ治疗6月后仍有38%患者甲状腺功能亢进,使用他巴唑组甲亢比例为23%,而碳酸锂组仅为9.6%,3组间比较均有显著性差异(α〈0.05);3组间发生甲减例数比较无显著性差异(P〉0.05)。结论在^131Ⅰ治疗Graves病前使用丙基硫氧嘧啶会降低^131Ⅰ治疗甲亢的疗效,其影响高于他巴唑组及碳酸锂组,3组中碳酸锂组对^131Ⅰ治疗甲亢的疗效影响最小。 相似文献
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不同疗程的抗甲状腺药物治疗Graves病对近期复发作用的前瞻性研究 总被引:5,自引:0,他引:5
目的比较不同疗程的抗甲状腺药物(ATD)治疗Graves病的缓解率,以探讨药物治疗Graves病的最佳疗程.方法经确诊的Graves病192例随机分为三组,即疗程12个月组,24个月组,36个月组.分别用他巴唑30mg/日,2~3个月后逐渐减量至半年减为维持量,并均加用左旋甲状腺素50μg/日,直至各疗程结束并随访2年统计其复发率.结果停药后随访2年内3组复发率分别为69%、38.2%和21.2%,3组间比较差异均有显著性(P均<0.01),TSAb水平在Ⅱ、Ⅲ组均较Ⅰ组显著降低(P<0.05),但Ⅱ、Ⅲ组之间差异无显著性.结论延长ATD治疗时间可明显提高Graves病的缓解率,以36个月组疗程为最佳. 相似文献
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^131Ⅰ治疗儿童和青少年Graves病的进展 总被引:3,自引:0,他引:3
顾佩莉 《国外医学:内分泌学分册》2005,25(6):377-379
^131I治疗儿童和青少年Graves病(GD)的成功率可达90%,甲状腺功能亢进(甲亢)患者接受^131I治疗后,甲状腺癌形成、性腺损伤及后代获得先天性畸形的风险没有明显的增加.年幼的GD儿童用^131I治疗,甲状腺癌的风险可能有较小程度的增加.^131I治疗对儿童甲状腺眼病的影响不大,也是安全的.^131I治疗的优点是安全、简单、经济、有效.对于抗甲状腺药物治疗无效或复发、不愿手术或手术后复发的儿童及青少年甲亢病人,^131I治疗是可供选择的一种较好的治疗方法,其可作为儿童及青少年甲亢的第二线治疗. 相似文献
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Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献
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Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献
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目的 探讨甲状腺刺激性抗体(TSAb)水平和甲状腺体积等相关因素对Graves病患者抗甲状腺药物治疗停药后复发的预测价值.方法 71例Graves病患者经抗甲状腺药物正规治疗(2.8±1.4)年后停药,随访(22±6.0)个月.对停药后复发与未复发组的年龄、性别及停药时的TSAb活性、甲状腺体积和甲状腺功能指标等进行分析比较.应用表达重组人促甲状腺激素受体的人胚肾(HEK-hTSHR)细胞测定TSAb活性.结果 71例患者随访期间有11例(15.5%)复发,治疗停药时TSAb阳性患者复发率(42.9%,6/14)显著高于阴性患者(8.8%,5/57,X2=9.97,P<0.01).停药时甲状腺正常体积、Ⅰ度肿大、Ⅱ度肿大复发比率分别为6.25%、12.2%、35.7%.复发组患者停药时TSAb活性、阳性率以及甲状腺体积均显著高于未复发组(P<0.05或P<0.01).结论 Graves病患者抗甲状腺药物治疗终止时TSAb活性和甲状腺大小是Graves病停药后复发的有效预测因子. 相似文献
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Graves病药物治疗停药复发相关因素分析 总被引:2,自引:1,他引:1
Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献
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Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献
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Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献
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Graves病药物治疗停药复发相关因素分析 总被引:2,自引:2,他引:0
Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献
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Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献
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Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs. 相似文献