Kuo S W, Hu C A, Pei D, Ni K B, Shian L R
Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
J Formos Med Assoc. 1993 Jan;92(1):55-60.
Patients with nontoxic thyroid nodules are often treated with thyroxine (T4) in order to reduce the size of the nodule, but the efficacy of thyrotropin-suppressive therapy with thyroxine remains uncertain. In this study, 35 patients with a solitary thyroid nodule were given thyroxine (0.1 mg/day) for three months. High resolution (7.5 MHz) sonography was used to measure the size of the nodules before and after thyroxine therapy. The volume of the nodules in 12 patients (34.3%, responders) decreased by more than 50% after thyroxine therapy. In this group, the mean serum thyroglobulin (Tg) level decreased significantly (from 424 to 107 ng/mL, p < 0.001). In the nonresponders, the mean serum Tg level did not change significantly after thyroxine therapy (291 vs 261 ng/mL, p > 0.05). The mean serum total T4 and free T4 concentrations increased significantly in both groups after thyroxine therapy (p < 0.01), the serum total triiodothyronine (T3) level did not change (p > 0.05), and the serum thyrotropin level (TSH) and T3/T4 ratio decreased markedly (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
患有无毒甲状腺结节的患者常接受甲状腺素(T4)治疗以缩小结节大小,但甲状腺素促甲状腺素抑制疗法的疗效仍不确定。在本研究中,35例孤立性甲状腺结节患者接受了为期三个月的甲状腺素(0.1毫克/天)治疗。使用高分辨率(7.5兆赫)超声检查来测量甲状腺素治疗前后结节的大小。12例患者(34.3%,反应者)的结节体积在甲状腺素治疗后减少了50%以上。在该组中,血清甲状腺球蛋白(Tg)平均水平显著降低(从424降至107纳克/毫升,p<0.001)。在无反应者中,甲状腺素治疗后血清Tg平均水平无显著变化(291对261纳克/毫升,p>0.05)。甲状腺素治疗后两组血清总T4和游离T4浓度均显著升高(p<0.01),血清总三碘甲状腺原氨酸(T3)水平无变化(p>0.05),血清促甲状腺素水平(TSH)和T3/T4比值显著降低(p<0.01)。(摘要截短于250字)