Zhang Xiao-Hong, Yuan Gao-Pin, Chen Ting-Li
Department of Pediatric Endocrinology, Quanzhou Women and Children's Hospital, Quanzhou 362000, Fujian Province, China.
World J Clin Cases. 2022 Feb 6;10(4):1190-1197. doi: 10.12998/wjcc.v10.i4.1190.
The incidence of toxic diffuse goiter (Graves' disease) is higher in adolescents and preschool-aged children, with an upward trend. The incidence at 6-13 years of age is approximately 11.0%, and the incidences in men and women are 7.8% and 14.3%, respectively.
To explore the clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter (Graves' disease) in children and its effect on serum anti-thyroglobulin antibody (TRAb) and anti-thyroid peroxidase antibody (TPOAb).
A total of 103 children with Graves' disease treated in our hospital from January 2018 to June 2021 were divided into a traditional group and a combined group (15-20 mg methimazole orally given to children) and a combined group (50 µg selenium added on the basis of traditional treatment) according to different treatment methods to explore the therapeutic effects of the two methods and to observe the changes in thyroid volume and serum TRAb, TPOAb, free thyroxine (FT4) and inflammatory factor levels before and after treatment. The time taken for FT4 to return to normal was compared between the two groups.
Treatment was significantly more effective in the combined group than in the traditional group ( < 0.05). The thyroid volumes of the children in the two groups was measured before and after treatment. Thyroid volume decreased significantly after treatment in both groups, and the thyroid volume was significantly lower in the combined group than in the traditional group ( < 0.05). The serum levels of interleukin-6 (IL-6), IL-8, TRAb, TPOAb and FT4 in the two groups were detected before and after treatment. The levels of IL-6, IL-8, TRAb, TPOAb and FT4 were significantly lower in the combined group than in the traditional group ( < 0.05). Follow-up of the children in the two groups showed that compared with the traditional group, it took less time for children in the combined group to return to the normal level ( < 0.05).
Methimazole combined with selenium can effectively treat Graves' disease in children, reduce the expression of TRAb, TPOAb, FT4 and inflammatory factors, and improve the curative effect. Thus, the combined treatment warrants further clinical research.
毒性弥漫性甲状腺肿(Graves病)在青少年和学龄前儿童中的发病率较高,且呈上升趋势。6至13岁的发病率约为11.0%,男性和女性的发病率分别为7.8%和14.3%。
探讨甲巯咪唑联合硒治疗儿童毒性弥漫性甲状腺肿(Graves病)的临床效果及其对血清抗甲状腺球蛋白抗体(TRAb)和抗甲状腺过氧化物酶抗体(TPOAb)的影响。
选取2018年1月至2021年6月在我院治疗的103例Graves病患儿,根据不同治疗方法分为传统组(给予患儿口服甲巯咪唑15 - 20mg)和联合组(在传统治疗基础上加用50μg硒),探讨两种方法的治疗效果,观察治疗前后甲状腺体积及血清TRAb、TPOAb、游离甲状腺素(FT4)和炎症因子水平的变化。比较两组FT4恢复正常所需时间。
联合组治疗效果明显优于传统组(P<0.05)。测量两组患儿治疗前后的甲状腺体积。两组治疗后甲状腺体积均显著减小,且联合组甲状腺体积明显低于传统组(P<0.05)。检测两组患儿治疗前后血清白细胞介素-6(IL-6)、IL-8、TRAb、TPOAb和FT4水平。联合组IL-6、IL-8、TRAb、TPOAb和FT4水平明显低于传统组(P<0.05)。对两组患儿进行随访,结果显示,与传统组相比,联合组患儿恢复至正常水平所需时间更短(P<0.05)。
甲巯咪唑联合硒可有效治疗儿童Graves病,降低TRAb、TPOAb、FT4及炎症因子的表达,提高治疗效果。因此,该联合治疗值得进一步临床研究。