彩色多普勒超声检查在抗甲状腺药物治疗Graves病预后判断中的价值

毒性弥漫性甲状腺肿，即Graves病（GD）是甲状腺机能亢进的最常见的致病因素，抗甲状腺药物（ATD）是治疗GD选择较多的手段，但撤药后复发率高，部分患者预后不尽人意。预测ATD治疗GD预后的指标很多，但都不够完善。彩色多普勒超声在预测GD患者经ATD治疗后复发方面有一定价值。如诊断GD时彩色多普勒超声显示甲状腺体积明显增大，平均收缩期峰血流值和体积流量值分别高于139cm／s和195ml／min的患者治疗后复发可能性大。撤药后甲状腺低回声的程度越低，则GD缓解的可能性越大。这些指标均有利于临床医师更好地选择治疗方案并调整治疗周期，使GD患者的药物治疗达到更高的长期缓解率。

Value of Doppler sonography in predicting relapse of Graves' disease after antithyroid drug therapy

Graves＇ disease（GD） is the most common hyperthyroidism. Antithyroid drug（ATD） therapy is the main treatment option for GD. However, parts of patients would relapse after ATD withdraw. There＇re many indexes helpful in judging the prognosis of GD after ATD withdraw, however, not all of them are reliable. It is reported that Doppler sonography is useful in predicting relapse of GD after ATD therapy. For example, patients with mean peak systolic velocity and volume flow rate values which measured by Doppler sonography at the time of diagnosis higher than 139 cm/s and 195 ml/min, respectively, may tend to relapse after methimazole treatment. Significantly enlarged thyroid measured at diagnosis was related to higher risk of recurrence, while the absence or a low grade of thyroid hypoechogenieity after methimazole treatment seemed to be a favourable prognostic index of remission. In a word, Doppler sonography could be helpful in predicting relapse, proper planning of GD therapy and getting a higher rate of remission.