Cox Stephanie C, Tamatea Jade Au, Conaglen John V, Elston Marianne S
Department of Endocrinology, Waikato Hospital, Private Bag 3200 Hamilton, 3420, New Zealand.
N Z Med J. 2016 Jun 10;129(1436):10-24.
Treatment options for Graves' disease (GD), namely anti-thyroid drugs (ATD), surgery or radioiodine (RAI), have not changed over the past two decades. There is no 'gold-standard' treatment for GD.
To assess whether the management of GD in New Zealand has changed since the previous 1991 New Zealand survey and compare current management with that of contemporary international studies.
We conducted an online survey of New Zealand physicians currently practising internal medicine, diabetes and/or endocrinology, using the cases and questions from the original European and 1991 New Zealand studies.
The first-line use of RAI was 5.5%, compared to 41% in the 1991 New Zealand survey. This corresponded to an increase in ATD use, while the rates of surgery as a first-line treatment have remained static over time. New Zealand physicians use technetium scanning for diagnosis, whereas ultrasound and radioiodine uptake were the most commonly selected investigations by European and North American physicians, respectively. The pattern of ATD use in pregnancy was similar to international practice.
Treatment of GD in New Zealand has shifted away from the use of RAI as first line treatment. There are significant differences in the investigation and treatment of Grave's disease between New Zealand, Europe and North America.
过去二十年来，格雷夫斯病（GD）的治疗选择，即抗甲状腺药物（ATD）、手术或放射性碘（RAI），并未发生改变。GD没有“金标准”治疗方法。
评估自1991年新西兰上一次调查以来，新西兰GD的管理是否发生变化，并将当前管理与当代国际研究进行比较。
我们使用来自最初的欧洲研究和1991年新西兰研究的病例及问题，对新西兰目前从事内科、糖尿病和/或内分泌学的医生进行了在线调查。
放射性碘作为一线治疗的使用率为5.5%，而在1991年的新西兰调查中为41%。这对应着抗甲状腺药物使用的增加，而作为一线治疗的手术率随时间保持稳定。新西兰医生使用锝扫描进行诊断，而欧洲和北美医生分别最常选择超声和放射性碘摄取检查。妊娠期间抗甲状腺药物的使用模式与国际惯例相似。
新西兰GD的治疗已不再将放射性碘作为一线治疗方法。新西兰、欧洲和北美在格雷夫斯病的检查和治疗方面存在显著差异。
