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抗甲状腺药物治疗格雷夫斯病的结果。90例报告(作者译)

[Results of treatment of Graves' disease by antithyroid drugs. Report of 90 cases (author's transl)].

作者信息

Duprey J, Colliard M

出版信息

Ann Endocrinol (Paris). 1981 Jul-Sep;42(3):233-49.

PMID:6172076
Abstract

Ninety patients with Graves' disease were given treatment with antithyroid drugs. The first course, which is almost always immediately successful, gave in the long term 46 failures and 44 successes. Among the latter, 38 had a follow up equal or greater than one year after interruption of the course. Among the 78 cases sufficiently well followed up for the whole period of treatment (of which 21 had at least two courses of treatment), we noted 23 failures and 55 successes (70%) for which the average follow up was 61 months. If one requires a follow up equal or greater than one year after the end of treatment, we noted 47 good results out of 70 fully documented cases, i. e. 67%. The possible failures almost always occurred less than one year after the end of treatment. The delay since the last interruption of antithyroid drugs is thus of prognostic value. The result of treatment was not found to be related to any of the clinical or laboratory parameters found during the initial stage of the disease, nor with the type of antithyroid drug used. The addition of thyroid hormone to antithyroid drugs does not seem to be of any use. On the other hand, delay in starting treatment seems to favour the failure of treatment. Other interesting prognostic factors may be sought in the kinetics of TSH, the T3-suppressibility, the early radioiodine uptake, the estimation of thyrostimulating antibodies, and the study of HLA histocompatibility antigens.

摘要

90例格雷夫斯病患者接受了抗甲状腺药物治疗。第一个疗程几乎总是立即见效,但从长远来看,有46例治疗失败,44例成功。在成功的患者中,38例在疗程中断后随访时间等于或超过一年。在整个治疗期间有足够随访资料的78例患者(其中21例至少接受了两个疗程的治疗)中,我们记录到23例失败和55例成功(70%),平均随访时间为61个月。如果要求在治疗结束后随访时间等于或超过一年,在70例有完整记录的病例中,我们记录到47例良好结果,即67%。可能的治疗失败几乎总是发生在治疗结束后不到一年的时间。因此,自上次中断抗甲状腺药物治疗后的时间具有预后价值。未发现治疗结果与疾病初始阶段发现的任何临床或实验室参数有关,也与所用抗甲状腺药物的类型无关。在抗甲状腺药物中添加甲状腺激素似乎没有任何作用。另一方面,开始治疗的延迟似乎会导致治疗失败。其他有趣的预后因素可能可以从促甲状腺激素的动力学、T3抑制性、早期放射性碘摄取、促甲状腺刺激抗体的评估以及HLA组织相容性抗原的研究中寻找。

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