抗甲状腺药物联合曲安西龙对Graves病的疗效

The Therapeutic Effect of Triamcinolone on Antithyroid Drugs Treatment on Graves Disease

目的研究抗甲状腺药物联合糖皮质激素曲安西龙对Graves病的治疗效果。方法收集临床确诊的60例Graves病患者,随机分为单纯抗甲状腺药物组(A组)和联合曲安西龙组(B组),两组于治疗前和治疗后4个月分别测定血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、甲状腺过氧化酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)的含量。B组还测量血浆皮质醇、促肾上腺皮质激素(ACTH)、血浆葡萄糖水平。结果 A组治疗后FT4的含量较治疗前有所下降(P<0.05),TSH的含量略有上升,TPOAb和TGAb未见明显下降(P>0.05)。B组治疗后TSH较治疗前明显上升(P<0.01),FT3、FT4的含量和TPOAb、TGAb明显下降(P<0.01)。与A组比较,B组的血清TPOAb、TGAb下降和TSH上升,改善更明显(P<0.01)。结论抗甲状腺药物与曲安西龙联合应用能更快恢复甲状腺功能,抑制甲状腺的自身免疫反应,可能使Graves病更快康复并且减少复发。

Objective To observe the therapeutic effect of antithyroid drugs plus glucocorticoid （triamcinolone） on Graves disease. Methods Totally 60 patients with Graves disease were randomized into 2 groups： antithyroid drugs group （group A） and antithyroid drugs combined with triamcinolone group （group B）. The two groups were measured by serum free triiodothyronine （FT3）, free thyroxine （FT4）, thyroid-stimulating hormone （TSH）, anti-thyroglobulin antibody （TGAb） and anti-thyroperoxldase antibody （TPOAb） before and 4 months after treatment. Group B was also measured by cortisol, adrenocorticotropic hormone （ACTH）, plasma glucose. Results After 4 months treatment, the levels of serum FT4 and TSH were improved in both groups, but the levels of TSH in group B were improved more significantly; and the levels of TGAb and TPOAb in group A had no significant change. Compared with the group A, the levels of TGAb and TPOAb in group B were significantly lower （P〈0.01）. Conclusion The therapy of antithyroid drugs plus triamcinolone can significantly restore the thyroid function, and inhibit the thyriod autoimmune reaction, so graves disease will present faster recovery and less recurrence.