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目的观察不同剂量甲巯咪唑治疗Graves病的临床疗效,研究治疗前后其雌激素水平变化。方法 56例病例随机分为低剂量组(15mg/d,一次口服)和常规剂量组(30mg/d,分3次服),每组各28例。观察治疗治疗3个月后临床疗效及副反应,检测用药前及用药后3个月白血病计数、转氨酶(ALT、AST)水平、甲状腺激素(FT3、FT4)、促甲状腺激素释放激素(TSH)及雌激素(E2)水平,18-24月停药,随访2年复发率。结果治疗3个月后,两组临床疗效无显著性差异(P>0.05),FT3、FT4、TSH及E2水平较治疗前显著性减低(P<0.05),低剂量组副反应发生率较常规剂量组显著性减低(P<0.05),两组随访复发率无差异(P>0.05)。结论低剂量给药可以达到治疗Graves病的同时减低副反应发生率,雌激素与Graves病发生具有一定相关性。
Objective To observe the clinical efficacy of different doses of methimazole in the treatment of Graves’ disease and to study the changes of estrogen levels before and after treatment. Methods 56 cases were randomly divided into low dose group (15mg / d, once orally) and conventional dose group (30mg / d, 3 times), 28 cases in each group. The clinical efficacy and side effects were observed 3 months after treatment. The levels of leukemia, aminotransferase (ALT), thyroid hormones (FT3, FT4), thyrotropin releasing hormone (TSH) Estrogen (E2) levels, 18-24 months withdrawal, followed up for 2 years the recurrence rate. Results After 3 months of treatment, there was no significant difference in the clinical efficacy between the two groups (P> 0.05). The levels of FT3, FT4, TSH and E2 were significantly lower than those before treatment (P <0.05) (P <0.05). There was no difference in the recurrence rate between the two groups (P> 0.05). Conclusion Low-dose administration can reduce the incidence of side effects while treating Graves ’disease, and estrogen has some correlation with Graves’ disease.