^(131)Ⅰ联合泼尼松治疗Graves眼病的疗效观察

the ^(131)Ⅰ combined with low dose prednisone treatment for Grave's Ophthalmopathy

目的探讨131Ⅰ联合小剂量泼尼松治疗甲状腺功能亢进症Graves病(简称甲亢)的疗效及甲状腺功能减退(甲减)的发生率,突眼的变化。方法随机将58例甲亢患者,分对照组30例,采用一次性口服131Ⅰ治疗,平均剂量为200.5mbq(167.6-256.4mbq),观察6个月甲亢未愈者给予第2次治疗。治疗组28例,采用131Ⅰ联合小剂量泼尼松口服,在131Ⅰ治疗后第5天加服泼尼松30mg/d,连用4周,逐渐减量至5mg/d,维持2～3个月。结果观察两组治疗1年后的各项指标:疗效,甲状腺体积的改变,甲减发生率,两组比较差异无统计学意义(P>0.05)。突眼改变,治疗组突眼缓解率89%,对照组突眼缓解率47%,两组比较差异有统计学意义(P<0.01)。结论 131Ⅰ联合小剂量泼尼松治疗甲亢性突眼疗效满意。

Objective To observe the clinical effect of the 131Ⅰcombined with low dose Prednisone on Graves＇ hyperthyroidism（as hyperthyroidism for short） and the incidence of hypothyroidism,exophthalmic changes.Methods 58 cases with hyperthyroidism were randomly divided into two groups.Control group of 30 patients were treated with single oral dose of 131Ⅰ,the average dose of 200.5 mbq（167.6～256.4 mbq）.The patients who were not cured after 6 months were given a second treatment.Treatment group of 28 cases were treated with oral 131Ⅰ and low dose prednisone,the fifth day after treatment by 131Ⅰcontinue to take prednisone 30 mg/day for 4 weeks,gradually tapered to 5 mg/day to maintain 2～3 months.Results One year ofter treatment,some indexes were observed.Efficacy,thyroid volume change,the incidence of hypothyroidism,the difference between the two groups was not significant（P 0.05）.The remission rate of exophthalmic change in the treatment group was 89%,as in the control group was 47%,the difference was significant（P0.01）.Conclusion 131Ⅰ combined with low dose prednisone treatment for Grave＇s ophthalmopathy has satisfactory effect.