Berglund J, Christensen S B, Dymling J F, Hallengren B
Department of Surgery, Lund University, Malmö General Hospital, Sweden.
J Intern Med. 1991 May;229(5):435-42. doi: 10.1111/j.1365-2796.1991.tb00371.x.
The incidence of recurrence and of hypothyroidism was determined in all new patients treated for thyrotoxicosis during the period 1970-1974 in an unselected, well-defined urban population. A total of 309 patients were followed up for a median time period of 108 (1-192) months. There was a cumulative incidence of 51% recurrence in patients who were treated with antithyroid drugs for Graves' thyrotoxicosis, whereas after surgery or radioiodine treatment there were few recurrences, but 32% and 78% cumulative incidences of hypothyroidism. There were no recurrences after surgery or radioiodine treatment in patients with toxic multinodular goitre or solitary toxic adenoma, but 29% and 40% cumulative incidences of hypothyroidism following radioiodine treatment. Late hypothyroidism occurred after surgery for Graves' thyrotoxicosis, and in all groups treated with radioiodine. Thus it is advisable that all patients with Graves' thyrotoxicosis, regardless of treatment, and all patients with toxic multinodular goitre or solitary toxic adenoma treated with radioiodine, should be followed up for many years, and probably for life.
1970年至1974年期间,在一个未经挑选、定义明确的城市人群中,对所有接受甲状腺毒症治疗的新患者的复发率和甲状腺功能减退发生率进行了测定。总共309名患者接受了随访,中位随访时间为108(1 - 192)个月。接受抗甲状腺药物治疗的格雷夫斯甲状腺毒症患者的累积复发率为51%,而手术或放射性碘治疗后复发较少,但甲状腺功能减退的累积发生率分别为32%和78%。毒性多结节性甲状腺肿或孤立性毒性腺瘤患者手术或放射性碘治疗后无复发,但放射性碘治疗后甲状腺功能减退的累积发生率分别为29%和40%。格雷夫斯甲状腺毒症手术后以及所有接受放射性碘治疗的组中均出现了晚期甲状腺功能减退。因此,建议所有格雷夫斯甲状腺毒症患者,无论接受何种治疗,以及所有接受放射性碘治疗的毒性多结节性甲状腺肿或孤立性毒性腺瘤患者,都应进行多年随访,可能需终身随访。