^(131)I与抗甲状腺药物治疗儿童和青少年Graves病的疗效比较

Comparison of Clinical Effect of ^(131)I and Antithyroid Drugs in Treatment of Graves’ Disease in Children and Adolescents

目的评价131I与抗甲状腺药物(ATD)治疗儿童和青少年Graves病的疗效。方法取7～16岁儿童和青少年Graves病患者15例,分为131I治疗组8例和ATD治疗组7例,随访2年,观察131I与ATD治疗后疗效、突眼发生率、甲状腺功能低下(甲低)发生率、甲亢复发率及不良反应的情况。结果 131I组治愈6例(6/8),好转1例(1/8),无效1例(1/8);ATD组治愈3例(3/7),好转2例(2/7),无效2例(2/7),两组疗效比较,131I组明显高于ATD组(P<0.01)。治疗后在甲低的发生率131I组高于ATD组(P<0.01);甲亢复发率131I组低于ATD组(P<0.01);发生突眼和对突眼改善的疗效上差异无统计学意义(P>0.01);出现甲亢性心脏病、肝功能受损、白细胞降低等不良反应方面131I组低于ATD组(P<0.01)。结论 131I治疗儿童和青少年Graves病综合疗效优于ATD,是一种疗效肯定、比较安全的方法 。

Objective To evaluate the efficacy of 131I and antithyroid drugs（ATD） treatment for Graves’disease in children and adolescents.Methods To take 15 cases Patients of Graves’disease in children and adolescents in 7 to 16 year-old,They were divided into 2 groups treated with 131I and ATD,The 131I treatment group were 8 patients and the ATD treatment group were 7 patients,All patients were followed up for 2 years.To compare the total curative effects、the incidence of Exophthalmos、the incidence of Hypothyroidism、 Recurrence rate of Hyperthyroidism and the adverse reactions.Results 131I treatment group cure 6cases（75%）,improve 1 case（12.5%）,invalid 1 case（12.5%）;ATD treatment group cure 3cases（42.86%）,improve 2 cases（28.57%）,invalid 2 cases（28.57%）,the difference between the two groups was statistically significant （P0.01）;131I treatment group was higher than ATD treatment group in the incidence of Hypothyroidism,But in recurrence rate of Hyperthyroidism and the adverse reactions respect,131I treatment group was lower than ATD treatment group,the differences between the two groups were statistically significant （P0.01）;The exophthalmos occurs and to improve the efficacy of the exophthalmos in two groups was no significant difference（P0.01）.Conclusion 131I radiation therapy was effective and security and in the treatment of Graves’disease in children and adolescents and was better than antithyroid drugs.