Koutras D A, Piperingos G D, Pallas D, Katsouyanni K, Karaiskos K S, Marafelia P, Makriyannis D, Kitsopanides J, Sfontouris J, Mantzos J
University of Athens, Department of Clinical Therapeutics, Greece.
Thyroidology. 1990 Aug;2(2):81-8.
We treated 204 patients with endemic nontoxic goiter with T4, T3 and KI, singly or in combination. Definitely nodular goiters were excluded, since the possibility of autonomy would be increased. Goiter size was evaluated before and 6 months after treatment clinically in a blind way, i.e. the observer (always the same) did not know either the pretreatment goiter size or the treatment the patient had received. At the same time various laboratory parameters were recorded. All the active treatments (but not placebo) resulted in a highly significant decrease in the gland size. The effectiveness decreased in the following order: 1) T3 50 micrograms/d (most effective), 2) (T4 50 micrograms/d + T3 12.5 micrograms) x 2, 3) T4 150 micrograms + iodide 150 micrograms/d, 4) T4 75 micrograms + T3 18.75 micrograms/d, 5) T4 200 micrograms/d, 6) T3 37.5 micrograms/d, 7) Iodide 300 micrograms/d, 8) T4 150 micrograms/d, 9) Iodide 150 micrograms/d (least effective) and 10) Placebo (not effective). The results show that T4 200 micrograms and T3 50 micrograms are roughly equipotent, and slightly more effective than 300 micrograms of Iodide. Taking into consideration the side effects (increase in pulse rate, shortening of the Achilles tendon reflex) did not change the order of effectiveness in an important way. The clinical outcome correlated in general with the suppression of the 131I uptake (r = 0.220, p = 0.03) and the TRH test (r = 0.248, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
我们采用T4、T3和碘化钾单独或联合治疗204例地方性非毒性甲状腺肿患者。明确排除结节性甲状腺肿，因为其自主性可能性会增加。以盲法临床评估治疗前及治疗6个月后的甲状腺肿大小，即观察者（始终为同一人）既不知道治疗前甲状腺肿大小，也不知道患者接受的治疗。同时记录各种实验室参数。所有积极治疗（而非安慰剂）均使腺体大小显著减小。有效性按以下顺序降低：1）T3 50微克/天（最有效），2）（T4 50微克/天 + T3 12.5微克）×2，3）T4 150微克 + 碘化物150微克/天，4）T4 75微克 + T3 18.75微克/天，5）T4 200微克/天，6）T3 37.5微克/天，7）碘化物300微克/天，8）T4 150微克/天，9）碘化物150微克/天（最无效），10）安慰剂（无效）。结果表明，T4 200微克和T3 50微克大致等效，且比300微克碘化物略有效。考虑到副作用（脉搏率增加、跟腱反射缩短）并未显著改变有效性顺序。临床结果总体上与131I摄取抑制（r = 0.220，p = 0.03）和促甲状腺激素释放激素试验（r = 0.248，p = 0.001）相关。（摘要截断于250字）
