Roti E, Gardini E, Minelli R, Bianconi L, Braverman L E
Cattedra di Endocrinologia, Universitá di Parma, Italy.
Metabolism. 1993 Apr;42(4):403-8. doi: 10.1016/0026-0495(93)90094-5.
A prospective study was conducted to evaluate the effect of prolonged treatment of hyperthryoid Graves' disease with methimazole (MMI) for 12 months or Na ipodate for only 6.6 +/- 1.1 months, since the drug had to be discontinued because of persistent or recurrent hyperthyroidism during treatment. The eight patients who were treated with MMI alone for 12 months became euthyroid, and seven remained in remission for at least 6 months after MMI was discontinued. In contrast, only two of 10 patients treated with Na ipodate alone became euthyroid and remained so during therapy. No ipodate was discontinued in the eight patients who did not respond, and they were then treated with MMI. One patient had recurrent hyperthyrodism after NA ipodate was discontinued, and she was then treated with MMI. MMI was efficacious in treating these nine patients, and all patients were euthyroid by the third month of MMI administration. Five of these nine patients remained euthyroid for at least 6 months after MMI was discontinued, a remission rate that was not significantly different from that observed in the eight patients treated only and initially with MMI (Fisher's Exact Test). There was no significant change in serum thyroid peroxidase antibodies during treatment with MMI alone, Na ipodate alone, or Na ipodate followed by MMI.(ABSTRACT TRUNCATED AT 250 WORDS)
开展了一项前瞻性研究,以评估用甲巯咪唑(MMI)对甲状腺功能亢进型格雷夫斯病进行12个月的长期治疗,或仅用碘番酸钠治疗6.6±1.1个月的效果,因为在治疗期间由于持续性或复发性甲状腺功能亢进不得不停用该药物。单独接受MMI治疗12个月的8例患者甲状腺功能恢复正常,并且在停用MMI后7例至少缓解了6个月。相比之下,单独接受碘番酸钠治疗的10例患者中只有2例甲状腺功能恢复正常并在治疗期间保持正常。8例无反应的患者未停用碘番酸钠,随后用MMI治疗。1例患者在停用碘番酸钠后出现复发性甲状腺功能亢进,随后用MMI治疗。MMI对这9例患者有效,在给予MMI的第三个月时所有患者甲状腺功能均恢复正常。这9例患者中有5例在停用MMI后至少6个月保持甲状腺功能正常,缓解率与仅最初接受MMI治疗的8例患者中观察到的缓解率无显著差异(费舍尔精确检验)。单独用MMI、单独用碘番酸钠或碘番酸钠后用MMI治疗期间,血清甲状腺过氧化物酶抗体无显著变化。(摘要截短于250字)