Rivkees S A
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA.
Curr Drug Targets Immune Endocr Metabol Disord. 2001 Nov;1(3):255-64. doi: 10.2174/1568008013341262.
Graves' disease is the most common form of hyperthyroidism in childhood. Current treatment options include antithyroid medications, surgery, and radioactive iodine. Medical therapy is generally associated with long term remission rates of less than 25% and a small risk of serious adverse reactions that include hepatic failure and bone marrow suppression. Total thyroidectomy is associated with very high cure rates and a small risk of hypoparathyroidism and recurrent laryngeal nerve damage. When radioactive iodine is used at appropriate doses, there is a very high cure rate without increased risks of thyroid cancer or genetic damage. Because of the theoretical risk of thyroid cancer after thyroid irradiation in individuals less than 20 years of age, relatively high doses of radioactive iodine should be administered to minimize the persistence of residual thyroid tissue.
格雷夫斯病是儿童期最常见的甲状腺功能亢进症形式。目前的治疗选择包括抗甲状腺药物、手术和放射性碘。药物治疗通常长期缓解率低于25%，且有发生严重不良反应的小风险，包括肝衰竭和骨髓抑制。全甲状腺切除术治愈率非常高，但有发生甲状旁腺功能减退和喉返神经损伤的小风险。当以适当剂量使用放射性碘时，治愈率非常高，且不会增加甲状腺癌或遗传损伤的风险。由于20岁以下个体甲状腺照射后存在甲状腺癌的理论风险，应给予相对高剂量的放射性碘，以尽量减少残留甲状腺组织的持续存在。
