抗甲状腺药物联合左旋甲状腺素治疗Graves病的临床分析

Clinical analysis of therapy with antithyroid drugs connected with L-T_4 for graves disease

目的探讨抗甲状腺药物(ATD)联合左旋甲状腺素(L-T4)治疗有明显甲状腺肿大和(或)突眼的Graves病的疗效.方法选择有明显甲状腺肿大和(或)突眼的初治Graves病患者100例,随机分成2组,治疗组应用ATD他巴唑(MMI)或丙基硫氧密啶(PTU)治疗4～8周,待T3,T4,TSH恢复正常时开始加·L-T4,对照组给以MMI或PTU,根据甲状腺功能逐渐减量.结果治疗组TRAb的阳性率由治疗前80.1%降至治疗结束16.6%,对照组由治疗前82.4%降至治疗结束时的43.5%,两组TRAb转阴率有显著差异.随访1～3年,治疗组复发7例,占14.6%,治愈41例,治愈率85.4%;对照组复发16例,占34.8%,治愈30例,治愈率65.2%,两组差别也有显著差异.结论有明显甲状腺肿大和(或)突眼的Graves病患者,ATD联合L-T4治疗可显著提高疗效.

Objection: To explore the connect ATD with L-T4 therapy results for Graves disease company significant thyroid and (or ) thyrotoxic ophthalmopathy. Methods: Selected that first treatment Graves disease company significant throid gland and thyrotoxic ophthalmopathy 100 cases, randomly divided into two groups, A groups were given ATD and L-T4, B groups were only given ATD. Results: TRAb converted negative rate of A groups from 80.1% down to 16.6% significantly higher than that of B groups from 82.4% down to 43.5%. But recurrence rate of A groups significantly low that of B groups. 7 cases recrudesced (14.6%), 41 cases cured (85.4%) in the treat group; 16 cases recrudesced (34.8%), 30 cases cured (65.2%) in the control group, and there is significant difference between them. Conclusions: Graves disease company significant thyroid gland and (or) thyrotoxic ophthalmopathy, connect ATD with L-T4 can significantly clinical effective.