Introduction:Antithyroid drugs are widely used in the treatment of Graves' disease(GD), but the relapse rate is very high after therapy withdrawal.We evaluated the reduction effects of intrathyroid injection of de...Introduction:Antithyroid drugs are widely used in the treatment of Graves' disease(GD), but the relapse rate is very high after therapy withdrawal.We evaluated the reduction effects of intrathyroid injection of dexamethasone(IID) on the relapse rate of hyperthyroidism in patients with newly diagnosed GD.Patients and Methods:A total of 191 patients with GD completed the study.After 6 months of treatment with methimazole(MMI), the patients were randomly assigned to receive either MMI(96 patients) alone or MMI combined with IID(MMI + IID;95 patients) treatment for 3 months, followed by continuing a dose of MMI that would maintain euthyroidism for the next 9 months in all of the patients.After withdrawal of the medical therapy, patients were followed for 24 months, and the relapse rate of hyperthyroidism was evaluated.Results:No statistical difference was observed in the levels of serum FT4, TSH, or TSH receptor antibodies(TR-Ab), the thyroid volume, or the TR-Ab positive rate between the two groups at month 6.After the next 3 months of treatment with MMI + IID or MMI alone, the levels of TSH increased significantly, and the levels of serum TR-Ab, the TR-Ab positive rate, and thyroid volume decreased significantly in the MMI + IID group compared with the MMI group.Seven patients(7.4%) experienced a relapse of overt hyperthyroidism in the MMI + IID group and 49 patients(51%) in MMI group during the 2-yr follow-up period(P < 0.001).Conclusions:MMI + IID treatment is helpful to prevent relapse of hyperthyroidism in GD after medical therapy withdrawal.展开更多
目的:通过文献荟萃分析评价利妥昔单抗治疗中重度甲状腺相关眼病的疗效。方法:检索中国知网(CNKI)、万方、维普、中国生物医学、PubMed、Web of Science、OVID、Corhone Library、ClinicalTrial.gov等数据库从建库至2019-12-31发表的关...目的:通过文献荟萃分析评价利妥昔单抗治疗中重度甲状腺相关眼病的疗效。方法:检索中国知网(CNKI)、万方、维普、中国生物医学、PubMed、Web of Science、OVID、Corhone Library、ClinicalTrial.gov等数据库从建库至2019-12-31发表的关于利妥昔单抗治疗中重度甲状腺相关眼病的临床研究。以治疗前后甲状腺相关眼病的临床活动评分为疗效的主要判定指标。将检索到的文献应用RevMan 5.3统计学软件进行分析。结果:纳入了6项研究61例患者,其中2项为随机对照试验,4项为队列研究。Meta分析显示,应用利妥昔单抗治疗中重度甲状腺相关眼病,可使患者的临床活动评分显著降低[SMD=-5.04,95%CI(-7.08^-3.01),P<0.00001]。结论:利妥昔单抗可使中重度甲状腺相关眼病患者的临床活动评分显著下降,对疾病的控制有良好效果。展开更多
文摘Introduction:Antithyroid drugs are widely used in the treatment of Graves' disease(GD), but the relapse rate is very high after therapy withdrawal.We evaluated the reduction effects of intrathyroid injection of dexamethasone(IID) on the relapse rate of hyperthyroidism in patients with newly diagnosed GD.Patients and Methods:A total of 191 patients with GD completed the study.After 6 months of treatment with methimazole(MMI), the patients were randomly assigned to receive either MMI(96 patients) alone or MMI combined with IID(MMI + IID;95 patients) treatment for 3 months, followed by continuing a dose of MMI that would maintain euthyroidism for the next 9 months in all of the patients.After withdrawal of the medical therapy, patients were followed for 24 months, and the relapse rate of hyperthyroidism was evaluated.Results:No statistical difference was observed in the levels of serum FT4, TSH, or TSH receptor antibodies(TR-Ab), the thyroid volume, or the TR-Ab positive rate between the two groups at month 6.After the next 3 months of treatment with MMI + IID or MMI alone, the levels of TSH increased significantly, and the levels of serum TR-Ab, the TR-Ab positive rate, and thyroid volume decreased significantly in the MMI + IID group compared with the MMI group.Seven patients(7.4%) experienced a relapse of overt hyperthyroidism in the MMI + IID group and 49 patients(51%) in MMI group during the 2-yr follow-up period(P < 0.001).Conclusions:MMI + IID treatment is helpful to prevent relapse of hyperthyroidism in GD after medical therapy withdrawal.
文摘目的:通过文献荟萃分析评价利妥昔单抗治疗中重度甲状腺相关眼病的疗效。方法:检索中国知网(CNKI)、万方、维普、中国生物医学、PubMed、Web of Science、OVID、Corhone Library、ClinicalTrial.gov等数据库从建库至2019-12-31发表的关于利妥昔单抗治疗中重度甲状腺相关眼病的临床研究。以治疗前后甲状腺相关眼病的临床活动评分为疗效的主要判定指标。将检索到的文献应用RevMan 5.3统计学软件进行分析。结果:纳入了6项研究61例患者,其中2项为随机对照试验,4项为队列研究。Meta分析显示,应用利妥昔单抗治疗中重度甲状腺相关眼病,可使患者的临床活动评分显著降低[SMD=-5.04,95%CI(-7.08^-3.01),P<0.00001]。结论:利妥昔单抗可使中重度甲状腺相关眼病患者的临床活动评分显著下降,对疾病的控制有良好效果。
