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短期碘化钾治疗儿童及青少年Graves病所致甲状腺毒症的效果

Effects of short-term potassium iodide treatment for thyrotoxicosis due to Graves disease in children and adolescents.

作者信息

Jeong Kyung Uk, Lee Hae Sang, Hwang Jin Soon

机构信息

Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.

出版信息

Ann Pediatr Endocrinol Metab. 2014 Dec;19(4):197-201. doi: 10.6065/apem.2014.19.4.197. Epub 2014 Dec 31.

Abstract

PURPOSE

Graves disease is the most common cause of hyperthyroidism in children. Inorganic iodide has been used in combination with antithyroid drugs for more effective normalization of thyroid hormones in some cases of severe thyrotoxicosis. This study aimed to investigate clinical characteristics of childhood thyrotoxicosis and effectiveness of inorganic iodide in the early phase of treatment.

METHODS

Sixty-seven pediatric patients (53 girls/14 boys, 11.1±3.4 years of age), with newly diagnosed thyrotoxicosis due to Graves disease were recruited. Forty-nine patients were treated with antithyroid drugs alone, while 18 patients were treated with combination of antithyroid drugs and potassium iodide. Initial thyroid function tests and levels of thyroid antibodies were recorded for all patients. Thyroid function tests were repeated 2 and 8 weeks after the initiation of treatment. Measurement thyroid antibodies were done 8 weeks after the initiation of treatment.

RESULTS

Mean triiodothyronine and free thyroxine levels were significantly lower (P<0.05) in the group receiving combined therapy of antithyroid drugs and potassium iodide after 2 weeks of treatment compared to the patients receiving antithyroid drugs alone. Eight weeks after the initiation of treatment, thyroid function tests in the two groups did not show significant differences.

CONCLUSION

The use of potassium iodide in combination with antithyroid drug is effective for more rapid normalization of thyroid hormones in the early phase treatment of childhood thyrotoxicosis, but larger studies with adequate power are needed in future.

摘要

目的

格雷夫斯病是儿童甲状腺功能亢进最常见的病因。在某些严重甲状腺毒症病例中,无机碘化物已与抗甲状腺药物联合使用,以更有效地使甲状腺激素恢复正常。本研究旨在调查儿童甲状腺毒症的临床特征以及无机碘化物在治疗早期的有效性。

方法

招募了67例因格雷夫斯病新诊断为甲状腺毒症的儿科患者(53名女孩/14名男孩,年龄11.1±3.4岁)。49例患者仅接受抗甲状腺药物治疗,而18例患者接受抗甲状腺药物与碘化钾联合治疗。记录所有患者的初始甲状腺功能测试和甲状腺抗体水平。治疗开始后2周和8周重复进行甲状腺功能测试。治疗开始8周后检测甲状腺抗体。

结果

与仅接受抗甲状腺药物治疗的患者相比,接受抗甲状腺药物与碘化钾联合治疗的组在治疗2周后平均三碘甲状腺原氨酸和游离甲状腺素水平显著降低(P<0.05)。治疗开始8周后,两组的甲状腺功能测试未显示出显著差异。

结论

碘化钾与抗甲状腺药物联合使用在儿童甲状腺毒症的早期治疗中能更迅速地使甲状腺激素恢复正常,但未来需要进行更有说服力的大型研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e0/4316415/b1ea1752f63e/apem-19-197-g001.jpg

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