Graves病甲状腺功能亢进首选糖皮质激素治疗作用和安全性研究

目的对Graves病甲状腺功能亢进(GD甲亢)初发和复发者首选糖皮质激素治疗,观察其不同给药途径、不同剂量的疗效及安全性。方法对101例GD患者据用药不同分三组,甲基强的松龙组(甲强龙,A组,n=46)40mg/d静滴,强的松(B组,n=27)30mg/d组,强的松(C组,n=28)15mg/d组。结果治疗2周时三组FT3、FT4水平较治疗前下降,差异有统计学意义(P0.01),但各组间比较差异无统计学意义。A、B两组减低FT3显效率均高于C组,差异有统计学意义(P0.05);A、B两组甲状腺缩小及肝损坏下降程度均大于C组(P0.05),且无明显不良反应的发生。结论糖皮质激素2周可明显降低甲状腺功能水平,使患者症状明显改善,并减少抗甲状腺药不良反应的危险性。

Effect and Safety of the First Choice of Glucorticosteroids Therapy in Patients with Graves' Hyperthyroidism

Objective To observe the effects and adverse reactions of different routes of administration and different doses of the corticosteroids therapy in new and recurrent Graves＇ hyperthyroidism. Methods 101 patients with GD were divided into 3 groups, named A, B and C Group. Group A （n=46） was treated with intravenous infusion of 40 mg methylprednisone once a day; Group B （n=27） was treated with orally 30mg prednisone once a day; Group C （n=28） was treated with orally 15mg prednisone once a day. Results After 2 weeks of treatment, FT3 and FT4 decline between three groups was no significant difference （P〉0.05）, but the excellent rate to reduce the serum FT3 levels in group A and B were significantly higher than that of group C after treatment （P〈0.05）; The decreases of thyroid size and ALT levels of group A and B were significantly greater than those in group C （P〈0.05）, and no significantly adverse reactions occurred. Conclusion ： These findings suggest that glueoeortieosteroids is an effective and safe way to treat GD. It can improve the clinical symptoms and reduce the risk of adverse reactions of anti-thyroid drugs.