目的:本文回顾性分析Graves病(GD)患者使用抗甲状腺药物(ATD)治疗后的临床资料,观察临床因素对GD患者治疗结果的影响因素。方法:收集2016年9月至2018年9月就诊于重庆医科大学附属第二医院内分泌科门诊随访并给予抗甲状腺药物治疗(ATD) ...目的:本文回顾性分析Graves病(GD)患者使用抗甲状腺药物(ATD)治疗后的临床资料,观察临床因素对GD患者治疗结果的影响因素。方法:收集2016年9月至2018年9月就诊于重庆医科大学附属第二医院内分泌科门诊随访并给予抗甲状腺药物治疗(ATD) 328例Graves病患者的临床资料,根据使用ATD后3年是否停药分为非难治性GD组(n = 66)和难治性GD组(n = 262),比较两组一般临床特征、甲状腺相关指标水平等,用多因素Logistic回归分析影响抗甲状腺药物治疗结果的相关因素。结果:与非难治性GD组相比,难治性GD组初诊时血清FT3、FT4、TRAb水平、TPOAB阳性率、甲状腺肿大率显著升高(P Objective: To retrospectively analyze the clinical data of patients with Graves’s disease treated with antithyroid drug (ATD), and to observe the influencing factors of clinical factors on the treatment results of GD patients. Methods: A total of 328 GD patients referred to the Second Affiliated Hospital of Chongqing Medical University between September 2016 to September 2018 were treated with antithyroid drugs. Patients were divided into non-refractory group (n = 66) and refractory group (n = 262) based on whether they stopped taking ATD for 3 years. The general clinical features and thyroid related indexes of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the related factors affecting the results of antithyroid drug therapy. Results: Compared with the non-refractory group, the levels of serum FT3, FT4, TRAb, the positive rate of TPOAB and the goiter rate in the refractory group were significantly higher (P < 0.05). The number of female patients was significantly higher than that of the male patients (P < 0.05). After treatment, the total course of treatment, serum TSH level, FT3 level and TRAB level in refractory group were significantly higher from those in non-refractory group (P < 0.05). Multivariate Logistic regression analysis showed goiter (OR = 2.997, P = 0.039), initial FT4 level (OR = 1.032, P = 0.005), initial TRAB level (OR = 2.509, P = 0.010), post-treatment TSH level (OR = 1.084, P = 0.008) and post-treatment TRAB level (OR = 1.066, P = 0.035) were risk factors for refractory Graves’ disease. Conclusion: There are many influencing factors in patients with Graves’ disease who cannot stop taking oral an-tithyroid drugs for more than 3 years. The level of TRAB, goiter, serum high free thyroxine and the levels of TSH and TRAB after treatment can be used as related indexes to predict the course of treatment and prognosis of the patients.展开更多
文摘目的:本文回顾性分析Graves病(GD)患者使用抗甲状腺药物(ATD)治疗后的临床资料,观察临床因素对GD患者治疗结果的影响因素。方法:收集2016年9月至2018年9月就诊于重庆医科大学附属第二医院内分泌科门诊随访并给予抗甲状腺药物治疗(ATD) 328例Graves病患者的临床资料,根据使用ATD后3年是否停药分为非难治性GD组(n = 66)和难治性GD组(n = 262),比较两组一般临床特征、甲状腺相关指标水平等,用多因素Logistic回归分析影响抗甲状腺药物治疗结果的相关因素。结果:与非难治性GD组相比,难治性GD组初诊时血清FT3、FT4、TRAb水平、TPOAB阳性率、甲状腺肿大率显著升高(P Objective: To retrospectively analyze the clinical data of patients with Graves’s disease treated with antithyroid drug (ATD), and to observe the influencing factors of clinical factors on the treatment results of GD patients. Methods: A total of 328 GD patients referred to the Second Affiliated Hospital of Chongqing Medical University between September 2016 to September 2018 were treated with antithyroid drugs. Patients were divided into non-refractory group (n = 66) and refractory group (n = 262) based on whether they stopped taking ATD for 3 years. The general clinical features and thyroid related indexes of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the related factors affecting the results of antithyroid drug therapy. Results: Compared with the non-refractory group, the levels of serum FT3, FT4, TRAb, the positive rate of TPOAB and the goiter rate in the refractory group were significantly higher (P < 0.05). The number of female patients was significantly higher than that of the male patients (P < 0.05). After treatment, the total course of treatment, serum TSH level, FT3 level and TRAB level in refractory group were significantly higher from those in non-refractory group (P < 0.05). Multivariate Logistic regression analysis showed goiter (OR = 2.997, P = 0.039), initial FT4 level (OR = 1.032, P = 0.005), initial TRAB level (OR = 2.509, P = 0.010), post-treatment TSH level (OR = 1.084, P = 0.008) and post-treatment TRAB level (OR = 1.066, P = 0.035) were risk factors for refractory Graves’ disease. Conclusion: There are many influencing factors in patients with Graves’ disease who cannot stop taking oral an-tithyroid drugs for more than 3 years. The level of TRAB, goiter, serum high free thyroxine and the levels of TSH and TRAB after treatment can be used as related indexes to predict the course of treatment and prognosis of the patients.
