Tamai H, Nakagawa T, Fukino O, Ohsako N, Shinzato R, Suematsu H, Kuma K, Matsuzuka F, Nagataki S
Ann Intern Med. 1980 Apr;92(4):488-90. doi: 10.7326/0003-4819-92-4-488.
The present study was undertaken to investigate whether there is a rational basis for the usual long periods of thionamide therapy in patients with hyperthyroid Graves' disease. Eighty untreated patients were given the minimum dose of thionamide drug needed to maintain serum thyroxine, triiodothyronine, and thyrotropin (TSH) concentrations within their normal ranges. Thyrotropin-releasing hormone (TRH) tests were done at 6 monthly intervals for 2 years. Among patients who had positive responses of TSH to TRH, approximately 10 patients every 6 months were asked to stop thionamide therapy and were followed up for at least 1 year after discontinuation of drugs. In the groups treated for 6, 12, 18, and 24 months, relapses occurred in nine of 13, five of nine, three of 12, and two of 11 patients, respectively. Values for thyroid function tests before and at the end of treatment were not different among these four groups of patients. The overall remission rates were not ascertained. However, a minimum of 1 year's treatment is recommended, at least in Japan.
本研究旨在探讨甲状腺功能亢进型格雷夫斯病患者通常需要长期接受硫代酰胺治疗是否有合理依据。80例未经治疗的患者服用维持血清甲状腺素、三碘甲状腺原氨酸和促甲状腺激素（TSH）浓度在正常范围内所需的最低剂量硫代酰胺药物。进行促甲状腺激素释放激素（TRH）试验，每6个月进行一次，持续2年。在TSH对TRH有阳性反应的患者中，每6个月约有10名患者被要求停止硫代酰胺治疗，并在停药后至少随访1年。在接受6个月、12个月、18个月和24个月治疗的组中，复发率分别为13例中的9例、9例中的5例、12例中的3例和11例中的2例。这四组患者治疗前和治疗结束时的甲状腺功能测试值没有差异。未确定总体缓解率。然而，至少在日本，建议至少进行1年的治疗。
