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目的探讨摄~(99m)Tc率在抗甲状腺药物(anti-thyroid drug,ATD)治疗Graves病停药后复发中的预测价值。方法纳入2011-05/2014-12作者医院Graves病患者461例,予以ATD规范治疗18~24个月,疗程结束时复查摄~(99m)Tc率,根据临床缓解标准将患者分为缓解组和未缓解组,对其摄~(99m)Tc率进行比较。根据停药时摄~(99m)Tc率将缓解组分为摄~(99m)Tc率高组和摄~(99m)Tc率正常组,随访12个月,对2组复发率和复发时间进行比较。结果经ATD治疗,临床缓解299例,未缓解162例,缓解率64.86%;未缓解组停药时摄~(99m)Tc率仍高者155例(95.68%),而缓解组摄~(99m)Tc率高者105例(35.12%)(P<0.01)。缓解组中摄~(99m)Tc率高组98例(93.33%)复发,摄~(99m)Tc率正常组45例(23.20%)复发(P<0.01),且前者复发时间明显早于后者[(3.51±0.82)月vs.(10.20±1.34)月,P<0.05]。结论摄~(99m)Tc率是ATD治疗Graves病停药复发有效预测指标。
Objective To investigate the predictive value of 99m Tc rate in relapse after stopping anti-thyroid drug (ATD) treatment of Graves disease. Methods A total of 461 patients with Graves’ disease admitted to our hospital from May 2011 to December 2014 were enrolled in this study. Patients were treated with ATD for 18-24 months. At the end of the treatment period, the 99m Tc rate was assessed. According to clinical remission criteria, patients were divided into remission group, The group did not remission, its ~ 99m Tc rate was compared. According to the Tc rate of ~ (99m) at the time of discontinuation, the remission was divided into two groups: high (99m) Tc rate group and normal 99m Tc rate group, followed up for 12 months. The recurrence rate and recurrence time Compare Results After ATD treatment, 299 cases were relieved and 162 cases were not relieved, the remission rate was 64.86%. 155 cases (95.68%) were still higher in ~ (99m) Tc group in non-remission group while 99m ) Tc rate was higher in 105 cases (35.12%) (P <0.01). In the remission group, 98 (93.33%) patients with high 99m Tc rate relapsed and 45 (23.20%) patients with normal 99m Tc rate relapsed (P0.01), and the former relapsed earlier than the latter [(3.51 ± 0.82) months vs. (10.20 ± 1.34) months, P <0.05]. Conclusion The 99m Tc rate is an effective predictor of the relapse of Graves disease with ATD.