OBJECTIVE:To determine whether clinical and biochemical features of Graves' disease at presentation predict response to medical and radioiodine treatment. METHODS:We carried out a retrospective 10-year study of 194 consecutive Saudi subjects with Graves' disease who were treated with antithyroid drugs, radioiodine therapy, or both, between January 1995 and December 2004 at King Khalid University Hospital, Riyadh, Saudi Arabia. RESULTS:At diagnosis, the mean age was 32 +/- 0.9 years. Only 26% of patients had successful outcome after a course of antithyroid medication. None of the clinical or biochemical factors were associated with a favorable outcome of antithyroid treatment. One dose of radioiodine [13-15 mCi (481-555 MBq)] cured hyperthyroidism in 83% of patients. Presence of ophthalmopathy at presentation was shown to be a significant contributing factor to failure to respond to a single dose of radioiodine (odds ratio, 6.4; 95% CI, 1.51-24.4; p<0.01). Failure of radioiodine treatment was also associated with higher serum free T3 concentration at presentation (p=0.003). CONCLUSION:In patients with Graves' hyperthyroidism, radioiodine treatment is associated with higher success rate than antithyroid drugs. A dose of 13-15 mCi (481-555 MBq) seems to be practical and effective, and should be considered as first line therapy. Patients with high free T3 concentration and, those with ophthalmopathy at presentation were more likely to fail radioiodine treatment. A higher dose of radioiodine may be advisable in such patients.

译文

目的:确定演讲时Graves病的临床和生化特征是否可预测对药物和放射碘治疗的反应。
方法:我们对1995年1月至2004年12月间在沙特阿拉伯利雅得国王哈立德大学医院接受抗甲状腺药物,放射碘疗法或两者同时治疗的194名连续Graves病的沙特受试者进行了为期10年的回顾性研究。
结果:在诊断时,平均年龄为32 /-0.9岁。接受抗甲状腺药物治疗后,只有26%的患者获得了成功的预后。没有任何临床或生化因素与抗甲状腺治疗的良好结果相关。一剂放射性碘[13-15 mCi(481-555 MBq)]可治愈83%的患者甲亢。出现眼部疾病被证明是导致对单剂量放射性碘反应失败的重要因素(优势比:6.4; 95%CI:1.51-24.4; p <0.01)。放射碘治疗失败还与出现时血清游离T3浓度升高有关(p = 0.003)。
结论:在格雷夫斯甲状腺功能亢进症患者中,放射性碘治疗比抗甲状腺药物成功率更高。 13-15 mCi(481-555 MBq)的剂量似乎是切实有效的,应视为一线治疗。游离T3浓度高的患者以及出现眼病的患者更有可能无法接受放射性碘治疗。在此类患者中建议使用更高剂量的放射性碘。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录