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
目的：研究2型糖尿病（T2DM）患者血清内脂素（visfatin）与24 h尿微量白蛋白（24 h U－mAlb）之间的相关性，探讨血清visfatin检测在早期糖尿病肾病诊断中的作用。方法选择T2DM患者86例，测定visfatin及24 h U－mAlb及其他各项生化指...目的：研究2型糖尿病（T2DM）患者血清内脂素（visfatin）与24 h尿微量白蛋白（24 h U－mAlb）之间的相关性，探讨血清visfatin检测在早期糖尿病肾病诊断中的作用。方法选择T2DM患者86例，测定visfatin及24 h U－mAlb及其他各项生化指标，按24 h U－mAlb分为单纯T2DM组（T2DM组，24 h U－mAlb＜30 mg）和早期2型糖尿病肾病组（T2DM 组，24 h U－mAlb 30～300 mg），同期选取60例健康人群作为正常对照组（NC组），进行visfatin、24 h U－mAlb及各项生化指标的检测。结果 T2DM组血清visfatin水平较NC组及T2DM组均明显升高（P＜0．01）；T2DM组较NC组visfatin水平明显增高（P＜0．01）。 Pearson 相关分析显示 Visfatin 与 BMI（r＝0．391，P＜0．01）、WHR（r＝0．308，P＜0．01）、HbA1c（r＝0．422，P＜0．05）、FPG（r＝0．204，P＜0．05）、24 h U－mAlb（r＝0．437，P＜0．01）呈正相关。结论血清visfatin对T2DM早期诊断中具有临床意义。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.
文摘目的：研究2型糖尿病（T2DM）患者血清内脂素（visfatin）与24 h尿微量白蛋白（24 h U－mAlb）之间的相关性，探讨血清visfatin检测在早期糖尿病肾病诊断中的作用。方法选择T2DM患者86例，测定visfatin及24 h U－mAlb及其他各项生化指标，按24 h U－mAlb分为单纯T2DM组（T2DM组，24 h U－mAlb＜30 mg）和早期2型糖尿病肾病组（T2DM 组，24 h U－mAlb 30～300 mg），同期选取60例健康人群作为正常对照组（NC组），进行visfatin、24 h U－mAlb及各项生化指标的检测。结果 T2DM组血清visfatin水平较NC组及T2DM组均明显升高（P＜0．01）；T2DM组较NC组visfatin水平明显增高（P＜0．01）。 Pearson 相关分析显示 Visfatin 与 BMI（r＝0．391，P＜0．01）、WHR（r＝0．308，P＜0．01）、HbA1c（r＝0．422，P＜0．05）、FPG（r＝0．204，P＜0．05）、24 h U－mAlb（r＝0．437，P＜0．01）呈正相关。结论血清visfatin对T2DM早期诊断中具有临床意义。
