回顾性分析格雷夫斯甲亢患者门诊治疗的转归

Retrospective analysis on prognosis of Graves hyperthyroidism treatment

目的回顾性分析格雷夫斯甲状腺功能亢进症(甲亢)患者不同方案治疗后5.0年的随访资料,为拟定适宜的治疗方案提供参考。方法选取1999年3月至2016年4月该院收治的经门诊诊断符合格雷夫斯甲亢患者11 798例,在门诊接受内科保守治疗或^(131)I治疗,其中具有完整5.0年随访资料患者4 622例,采用内科保守治疗的格雷夫斯甲亢患者2 405例(内科保守组),采用^(131)I治疗的格雷夫斯甲亢患者2 217例(^(131)I治疗组)。统计分析两组患者治疗后5.0年的随访资料,了解两组患者治疗后转归情况。结果内科保守组患者规整治疗停药后完全缓解率[55.84%(1 343/2 405)]、甲状腺功能减退症(甲减)发生率[2.82%(68/2 405)]均明显低于^(131)I治疗组[69.28%(1 536/2 217)、29.18%(647/2 217)],甲亢复发率[41.33%(994/2 405)]明显高于^(131)I治疗组[1.53%(34/2 217)],差异均有统计学意义(P<0.05)。结论内科保守治疗格雷夫斯甲亢患者甲减发生率、完全缓解率均较低,但复发率高;^(131)I治疗格雷夫斯甲亢患者甲减发生率、完全缓解率均较高,但复发率低。^(131)I治疗格雷夫斯甲亢患者优于内科保守治疗。

Objective A retrospective analysis of 5-year follow-up data was conducted on Graves hyperthyroidismpatients with different treatment methods,in order to provide reference for the formulation of appropriate treatment programmes.Methods A total of 11 798 patents,who were enrolled in the hospital from March 1999 to April 2016 and conformed to the criteria of Graves hyperthyroidism after diagnosis,were selected and received conservative treatment or 131I treatment. Among the4 622 patients with complete 5-year follow-up data,conservative medical treatment was performed in 2 405 patients（conservative medical group）,while 131I in 2 217 patients（131I treatment group）. The 5-year follow-up data and the prognosis in the two groups were analyzed. Results After treatment,the complete remission rate and the occurrence rate of hypothyroidism in the conservative medical group [55.84%（1 343/2 405）,2.82%（68/2 405）] were both obviously lower than those in the 131I group[69.28%（1 536/2 217）,29.18%（647/2 217）],while the recurrence rate of hyperthyroidism in the conservative medical group [41.33%（994/2 405）] was prominently higher than that in the 131I group [1.53%（34/2 217）],the difference had statistically significant difference（P〈0.05）. Conclusion The conservative medical treatment had lower ccurrence rate of hypothyroidism and complete remission rate,but higher recurrence rate,while the treatment had higher occurrence rate of hypothyroidism and complete remission rate,but lower recurrence rate. 131I treatment is better than conservative medical treatment in treating Graves hyperthyroidism.