摘要
目的探讨甲状腺内注射地塞米松和环磷酰胺治疗桥本氏甲状腺炎的疗效和安全性。方法24例临床诊断桥本氏甲状腺炎患者随机分为2组:(1)对照组,在观察期内未予特殊治疗;(2)甲状腺内注射组(注射组),甲状腺内注射地塞米松和环磷酰胺(地塞米松2.5mg、环磷酰胺20mg/侧/次。每周2次×8次,每周1次×4次,每2周1次×2次,共14次)。2组于治疗前及治疗后第3、6个月随访,检查症状、甲状腺肿、FT4、FT3、STSH、抗甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)、抗促甲状腺素受体抗体(TRAb)及肝肾功能,血、尿常规的改变。结果与对照组相比,甲状腺内注射地塞米松和环磷酰胺可使甲状腺体积缩小,发展为甲状腺功能减退症患者数减少,甲状腺相关的自身抗体水平下降,对肝肾功能和血尿常规无显著影响。结论甲状腺内注射地塞米松和环磷酰胺治疗桥本氏甲状腺炎疗效肯定且安全可靠,是一种值得进一步探索的治疗方法。
Objective To investigate the efficacy and safety of intrathyroidal injection of dexamethasone and cyclophosphamide on Hashimoto thyroiditis. Methods In a 9-month prospective study, 24 patients with Hashimoto thyroiditis were randomly divided into 2 groups： （1）control group; （2） treated with intrathyroidal injection. Dexamethasone 2.5mg and cyclophosphamide 20mg per side, twice per week for 4 weeks, once per week for 4 weeks, and then once every 2 weeks for 4 weeks, 14 times for all. The changes of thyroid volume, serum FT4, FT3, STSH, TGAb, TPOAb, TRAb and liver and kidney functions and other parameters were evaluated before and in 3 and 6 months after treatment. Results At end of the study, 4 patients with Hashimoto thyroiditis developed hypothyroidism （2 overt and 2 subclinic） in control group and none in the intrathyroidal injection group. Intrathyroidal injection is effective in shrinking goiter and improving pressure symptom on the neck, and reducing titres of thyroid autoantibodies. The liver and kidney functions remained unchanged. Conclusions Intrathyroidal injection of dexamethasone and cyclophosphamide is effective and safe in the treatment of Hashimoto thyroidism.
出处
《海南医学》
CAS
2008年第1期20-21,34,共3页
Hainan Medical Journal
关键词
桥本甲状腺炎
甲状腺内注射
环磷酰胺
地塞米松
Hashimoto thyroiditis
Intrathyroidal injection
dexamethasone
cyclophosphamide
