不同抗甲状腺药物对^131Ⅰ治疗Graves病近期疗效的比较

Comparative study on the therapeutic effect of radioactive iodine on Graves disease patients who had been treated with different antithyroid drugs

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。

Objective To compare the therapeutic effect of radioactive iodine on Graves disease patients who had been treated with different antithyroid drugs. Methods 98 cases with Graves disease were divided into three groups. The patients of the first group had been treated with propyhhiouracil, the second group had been treated with methimazole, the third group had been treated with lithium carbonate. The first two groups stopped taking medicine before the radioactive iodine treatment fifteen days ago. The group of lithium carbonate continue taking medicine until radioactive iodine reatment. Observe the effect of radioactive iodine treatment after six months later. Results The rate of hyperthyroidism in first group was 38 percent after the radioactive iodine treatment six months later. The rate of hyperthyroidism was 23 percent in the secnd group and 9.6 percent in the group of lithium carbonate. There were statistically significant differences with the cure rate between the three groups （ α 〈 0.05 ）. The rate of the onset of developing hypothyroidism was not statistically significant different between the three groups （ P 〉 0.05 ）. Conclusions Pretreatmemt with propyhhiouracil, methimazole or lithium carbonate could decrease cure rate of radioactive iodine treatment on Graves disease. Among the three kinds of medicine, propyhhiouracil has the greatest influence on the cure rate of radioactive iodine treatment and lithium carbonate has the least.