碘营养状况对Graves病抗甲状腺药物治疗的影响

THE EFFECT OF IODINE NUTRITION STATUS ON ANTI-THYROID MEDICINE FOR GRAVES DISEASE

①目的 观察山东沿海居民碘营养状况对Graves病抗甲状腺药物 (ATD)治疗的影响。②方法 采用 1∶1对照回顾 前瞻性方法 ,将Graves病病人分为沿海组和内陆对照组 ,观察两组Graves病首次缓解时间、维持期ATD剂量、1年反复率等。③结果 沿海Graves病组饮食碘、尿碘、甲状腺过氧化物酶抗体 (TPOAb)、甲状腺球蛋白抗体 (TGAb)、游离T3 (FT3 )、游离T4(FT4)高于内陆Graves病组 (t=2 .6 3～ 33.33,P <0 .0 1 )。沿海Graves病组首次缓解时间较内陆Graves病组明显延长 ,维持期ATD用量和 1年反复率也高于内陆Graves病组 (t=3.2 0、3.31 ,P <0 .0 1 ;χ2 =4 .1 6 ,P <0 .0 5 )。④结论 沿海Graves病病人在药物治疗中 ,应控制含碘物质的摄入量 ,以缩短病情缓解时间。

Objective To investigate the effect of iodine nutrition status on anti thyroid drugs( ATD ) in the treatment of Graves disease(GD)of inhabitants in coastal area of Shandong province. Methods Using 1∶1 retrospective and prospective methods, patients with Graves disease were divided into Coastal Group and Inland Group. The dosage of the drugs in the first remission and in maintaining period, and one year recurrence were observed for both groups. Results The iodine in diet, urine iodine, TPOAb, TGAb, FT 3 and FT 4 in coastal patients with GD were higher than those in Inland Group ( t=2.63-33.33, P < 0.01 ). The first remission greatly prolonged ,ATD dosage and one year recurrence were also high in Coastal Group ( t=3.20, 3.31 ,P<0.01; χ 2=4.16,P <0.05). Conclusion To shorten the remission time and reduce the recurrence, the intake of iodine has to be controlled in the treatment of GD patients living in coastal area using ATD.