Zhu Xinxin, Zhang Yaguang, Zhao Xiaoyu, Zhang Xiaona, Ru Zixuan, Wu Yanmeizhi, Yang Xu, Hou Boyu, Qiao Hong
Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Front Cardiovasc Med. 2022 Oct 28;9:1039829. doi: 10.3389/fcvm.2022.1039829. eCollection 2022.
Clinical relapse is a potential risk for traditional antithyroid drug (ATD) treatment in hyperthyroid patients. Evidence suggests that atherosclerotic disease is closely associated with hyperthyroidism, while the relationship between atherosclerosis and relapse remains unclear.
Two hundred and twenty-five patients with GD who underwent ATD as their first treatment were studied; 88 and 137 patients were categorized as drug reduction relapse and drug reduction remission, respectively. Logistic regression was used to analyze risk factors of drug reduction relapse in patients with GD.
During a median of 48 months followed up 88 patients who relapsed. According to multivariate analyses, atherosclerosis related diseases, FT4, goiter, and anxiety rating scores are independent risk factors for drug reduction. According to K-M survival analysis, patients with atherosclerosis related diseases, FT4 > 18.82 pmol/L, anxiety rating scores > 23, and gradation of goiter ≥ Grade II had a higher risk of relapse than those with lower levels. ROC analysis shown atherosclerosis related diseases significantly improved the predictive accuracy of relapse.
Atherosclerotic disease is closely related to the relapse of hyperthyroidism, ATD treatment in hyperthyroid patients with atherosclerosis should be given more attention.
临床复发是甲状腺功能亢进患者传统抗甲状腺药物（ATD）治疗的潜在风险。有证据表明，动脉粥样硬化疾病与甲状腺功能亢进密切相关，而动脉粥样硬化与复发之间的关系仍不清楚。
对225例首次接受ATD治疗的Graves病（GD）患者进行研究；88例和137例患者分别被归类为减药复发和减药缓解。采用逻辑回归分析GD患者减药复发的危险因素。
在中位随访48个月期间，88例患者复发。多因素分析显示，动脉粥样硬化相关疾病、游离甲状腺素（FT4）、甲状腺肿和焦虑评分是减药的独立危险因素。根据Kaplan-Meier生存分析，患有动脉粥样硬化相关疾病、FT4>18.82 pmol/L、焦虑评分>23以及甲状腺肿分级≥Ⅱ级的患者复发风险高于水平较低者。ROC分析表明，动脉粥样硬化相关疾病显著提高了复发的预测准确性。
动脉粥样硬化疾病与甲状腺功能亢进复发密切相关，对患有动脉粥样硬化的甲状腺功能亢进患者进行ATD治疗应给予更多关注。
