T_3抑制试验对预测长程内科治疗Graves甲亢患者预后的评价

本文报导166例未加选择的Graves甲亢患者的ATD治疗,评价T_3抑制试验在预测内科长程疗法预后的评价.72例达到抑制标准,抑制率为43.37%,径12～29月洽疗的45例中,18例停药后复发,复发率43.9%;27例经治疗30～64月后,3例复发,复发率为13.64%.94例非抑制患者中19例自动停药,11例复发,复发率57.89%.就抑制时间而言,约2/3的患者在开始治疗后三年内达到抑制标准

THE VALUE OF TRIIODOTHYRONINE (T_3) TEST FOR THE PREDICTION OF PROGNOSIS OF PATIENTS WITH GRAVES' DISEASE AFTER LONG-TERM MEDICAL TREATMENT

The value of T3 suppression test for the prediction of longterm medical treatment was studied in 166 unselected patients with Graves disease treated with thionamide. 72 patients, out of 166 satisfied criteria for suppression (suppression rate, 43.37%), of these, 45 patients (after 12-29months of treatment) were followed for 1-5 years and relapse occurred in 18 patients 2-36 months after stopping treatment(relapse incidence, 43.9%), 27 patients(after 30 -64 months of treatment) were followed for the same period and relapse occurred in only 3 patients 9-24 months after stopping treatment (relapse incidence, 13.64%). In 19 of 94 nonsuppressed patients interrupted medication and 11 experienced relapse 2-18 months after stopping treatment (relapse incidence, 57.89%). Comparison of suppressed group with the nonsuppressed group of (patients in respect to several clinical parameters (age, sex, goiter size, eye sign, serum T3, T4, T3RU, and 24 hour 131 uptake) yielded no clinical means for distinguishing the two groups with high reliability. As to the time course of suppression, it wasobserved that about two-thirds of the suppressed patients satisfied the criteria for suppression within 3 years of starting treatment. The time course of suppression in each patient could not be predicted from the result of initial thyroid tests. The overall remission rate among the 72 suppressed patients followed for 1-5 years was 60.98%. Our results confirm the usefulness of T3 suppression test for predicting sustained remission of Graves' disease after treatment, and clearly indicate that long-term medical therapy could increase the number of remission in the patients with Graves' disease.