Graves病的治疗方法多种,其中以抗甲状腺药物治疗为主,一般疗程12~18个月。最近半年小剂量抗甲状腺药物治疗下甲功正常、TRAb阴性一般可以停药,但停药后复发率高。准确掌握停药指针对于降低复发十分重要。研究表明停药时甲状腺体积大、ATD疗程短、偏高的TRAb水平、偏低TSH的水平、较快的甲状腺上动脉血流速度、较高的T3/fT4比值、较高的碘摄入、高NRL及低TPOAb和TgAb滴度等与停药后复发相关。因此在停用ATD之前,应该关注上述指标,避免不恰当停药导致复发。There are many treatments for Graves’ disease, among which antithyroid drugs are the main treatment, and the general course of treatment is 12~18 months. In the last six months, patients with normal thyroid function and negative TRAb can generally stop taking antithyroid drugs, but the recurrence rate is high after stopping taking them. It is very important to master the withdrawal indicator accurately to reduce recurrence. Studies have shown that the recurrence after drug withdrawal is related to large thyroid volume, short ATD course, high TRAb level, low TSH level, fast blood flow velocity of superior thyroid artery, high T3/fT4 ratio, high iodine intake, high NRL and low TPOAb and TgAb titers. Therefore, before stopping ATD, we should pay attention to the above indicators to avoid the recurrence caused by improper withdrawal.
甲状腺眼病(Thyroid eye disease, TED)是一种累及眼部的自身免疫性疾病。糖皮质激素是中至重度TED的首选药物治疗,治疗不佳者可能导致疾病进展,威胁患者视力,严重者可致残。全面了解TED的治疗方式及影响治疗效果的因素有助于评估疾病预后,尽早采取干预手段以避免患者出现严重的视力损害。本文结合近几年该方面的最新研究对此展开综述。Thyroid eye disease (TED) is an autoimmune disease involving the eye. Glucocorticoids are the preferred pharmacologic treatment for patients with moderate-to-severe TED. Inadequate treatment can lead to disease progression, potentially jeopardizing vision and resulting in disability in severe cases. A comprehensive understanding of the treatment modalities and factors affecting the outcome of TED is helpful in assessing the prognosis of the disease and in taking early interventions to prevent severe visual impairment. This article summarizes the latest research in this area in recent years.
