复发Graves病抗甲状腺药物或甲状腺次全切除术治疗的预后

Outcome of antithyroid treatment or subtotal thyroidectomy in relapsed Graves' disease

本文报告复发Graves病患者抗甲状腺药物(ATD)治疗(49例)和甲状腺次全切除术(次全切术)治疗(66例)后1～10年的预后,并分别与初发Graves病ATD或次全切术治疗的预后进行比较。复发患者49例ATD治疗的2、5、10年的缓解率分别为50％、32％和22.2％,均低于初发患者ATD治疗的缓解率(分别为65.6％、53.5％和39.7％)。复发患者66例次全切术治疗的2、5、10年的缓解率分别为96.8％、92％和85.2％,与初发患者次全切除术治疗的缓解率(分别为85％、82.6％和79％)相近。结果表明复发Graves病患者继续采用ATD治疗的效果较差,宜改用次全切术治疗。

The results of 1-10 year follow-up after antithyroid treatment or subtotal thyroidectomy in 115 patients with Graves' disease relapsed following treatment were reported The remission rates in 49 patients after second course of antithyroid treatment were 50% at 2 years, 32% at 5 Years and 22.2% at 10 years, which were lower than those in 266 patients with Graves' disease after first course of antithyroid treatment. The remission rates in 66 patients after subtotal thyroidectomy were 96.8% at 2 years, 92% at 5 years and 85.2% at 10 years, which were similar to those in 70 patients with Graves' disease after subtotal thyroidectomy as initial treatment. The results revealed that patients with Graves' disease relapsed after antithyroid treatment have poorer prognosis if they continued to receive antithyroid treatment. Thereby, it is better for them to take subtotal thyroidectomy or radioactive iodine therapy.