在患有格雷夫斯轨道病的患者中治疗甲状腺功能障碍的消耗性对保守的方法:回顾性队列研究
Giada Cosentino1, Giulia Lanzolla1, Simone Comi1
1Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy.
Thyroid : official journal of the American Thyroid Association
|February 5, 2025
概括
对Graves的甲状腺功能障碍的放射性 (RAI) 治疗可能会导致Graves的轨道病患者接受葡萄糖皮质类药物的早期反应. 长期结果相似,但RAI与更多的感染有关.
科学领域:
- 内分泌学 在内分泌学.
- 眼科医生 眼科 眼科
- 甲状腺疾病管理管理
背景情况:
- 在患有Graves的轨道病变 (GO) 的患者中,Graves的甲状腺功能增强症 (GH) 治疗受到争议.
- 在甲状腺治疗的同时,GO需要谨慎管理.
研究的目的:
- 为了研究葡萄糖皮质类药物治疗后的GO的结果,比较放射性 (RAI) 和甲基 (MMI) 对于GH.
主要方法:
- 对49名中度至重度活跃GO的GH患者进行了回顾性队列研究.
- 患者接受了静脉注射甲基普雷迪尼索隆,并通过RAI (24名患者) 或MMI (25名患者) 治疗GH.
- 根据预先定义的标准,在24,48,72周评估GO结果.
主要成果:
- 在第24周,RAI显示了响应者比例显著增加 (54.1%与16%).
- 48/72周,RAI和MMI组的长期GO结果和生活质量改善在RAI和MMI组之间是相似的.
- 感染在RAI组中更频繁 (53.8%对比15.3%).
结论:
- 与MMI相比,RAI可能与静脉注射葡萄皮质激素的早期GO反应有关.
- 长期有效性似乎相似,这表明保守的方法也可行.
- 随着同时进行葡萄糖皮质激素治疗,RAI似乎相对安全,尽管感染风险值得考虑.
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