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高剂量与低剂量阻断和替代治疗用于第一个格雷夫斯病发作
European thyroid journal
|April 2, 2025
概括
对格雷夫斯病 (GD) 的低剂量阻断和替代疗法与高剂量疗法同样有效. 这种方法使用较少的抗甲状腺药物 (ATD) 和levothyroxine,复发率相似,不增加不良事件.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 对格雷夫斯病 (GD) 第一次发作的最佳抗甲状腺药物 (ATD) 治疗进行了辩论.
- 阻断和替换 (B+R) 方案是GD常见的ATD治疗策略.
研究的目的:
- 为了比较高剂量 (HD) 与低剂量 (LD) B+R疗法的初始GD治疗的疗效和安全性.
- 为了评估复发率,类甲状腺症患病率和与不同B + R剂量相关的不良事件.
主要方法:
- 在两个学术中心对120名新诊断的GD患者 (1990-2022) 的回顾性研究.
- 患者接受了HD-B+R (固定的ATD剂量) 或LD-B+R (调整的ATD剂量) 至少12个月.
- 随访发生在治疗后至少1年或直到复发.
主要成果:
- 在6,12或18个月后,在HD和LD组之间没有观察到高甲状腺症率的显著差异.
- 甲状腺眼病的患病率和与ATD相关的不良事件在两组中都相似.
- 在第一个ATD疗程后,复发率相似 (63%的HD与60%的LD),尽管LD的ATD和levothyroxine剂量明显较低.
结论:
- 一个LD-B+R方案是HD-B+R的可行的替代方案,用于最初的格雷夫斯病治疗.
- 这种方法可以减少ATD和levothyroxine的剂量,而不会影响治疗的疗效或安全.
- 与较高剂量相比,低剂量的ATD治疗在预防复发方面表现出类似的有效性.
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