甲状腺功能亢进的三种治疗方法选择

Three treatment options for hyperthyroidism

甲状腺功能亢进(甲亢)是常见的内分泌代谢性疾病,其中最常见的病因是Graves病(GD)。GD的治疗主要有抗甲状腺药物、131I以及手术治疗三种方法。抗甲状腺药物和131I是目前治疗甲亢的常用方法,而手术治疗较少用。抗甲状腺药物因为治愈率较低及存在不良反应,在北美不作首选治疗,而在欧洲和亚洲则使用相对较多。在北美首选131I治疗甲亢,但引起的甲状腺功能减退常见,另外还有引起突眼或加重突眼的风险。在我国,131I治疗甲亢渐成趋势,但是以何种方法作为甲亢首选治疗,目前尚无共识。本文将着重介绍三种治疗GD的方法。

Hyperthyroidism is a common endocrine disease, and the most common cause is Graves disease（GD）. The anti-thyroid drugs（ATD）, 131 I and surgery are three main methods for the treatment of GD. Among them, ATD and 131 I are commonly used in the treatment of hyperthyroidism, while the surgical treatment is less used. It is not the first choice for ATD in North America because of the low cure rate and existence of adverse reactions, but it is more welcomed in Europe and Asia. The hyperthyroidism treatment with 131 I is the first choice in North America, however, it inevitably causes hypothyroidism and may induce or aggravates the exophthalmos. In our country, the 131 I treatment of hyperthyroidism becomes more and more popular, but as yet there is no consensus which method is the first choice. This article focuses on the introduction of the three methods for the treatment of GD.