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目的 探讨甲状腺动脉栓塞术治疗Graves病的中远期疗效。方法 对 2 5例因Graves病行介入治疗的患者进行了 2 4～ 5 7个月的中长期随访 ,分别于术前及术后 6个月和 1、2、3、4年观察血清总三碘甲状腺原氨酸 (T3)、血清总甲状腺素 (T4 )水平 ,同时观察心率、甲状腺体积。结果 2 5例患者均接受了双侧甲状腺上动脉栓塞治疗 ,其中有 11例甲状腺 2度以上肿大者尚栓塞了一侧甲状腺下动脉。栓塞剂选用白芨微球 +钢圈者 6例 ,聚乙烯醇微球 +钢圈者 19例。随访 2 4～ 5 7个月。随访时间达到 2年者有 2 5例 ,达到 3年者有 17例 ,达到 4年者有 8例。介入方法治疗Graves病的中远期治愈率达 88% (2 2 /2 5 ) ,2例术后尚需服用抗甲状腺药物、另 1例术后 12个月复发 ,所有患者均未发现甲状腺或甲状旁腺功能低下。结论 介入治疗Graves病具有较好的中远期疗效 ,是临床治疗难治性Graves病的有效方法。
Objective To investigate the long-term therapeutic effect of thyroid artery embolization on Graves disease. Methods Twenty-five patients with Graves’ disease underwent interventional therapy for 24 to 57 months. The patients were followed up for 6 months and 1, 2, 3 and 4 years respectively. Iodine thyroid acid (T3), serum total thyroxine (T4) levels, while observing heart rate, thyroid volume. Results Twenty-five patients underwent bilateral thyroid artery embolization. Eleven patients with enlarged thyroid more than 2 degrees still embolized the inferior thyroid artery. Embolism agent selected Baiji microspheres + steel ring in 6 cases, polyvinyl alcohol microspheres + steel ring in 19 cases. Follow-up was 2-4 months to 57 months. There were 25 cases with up to 2 years follow-up, 17 cases up to 3 years and 8 cases up to 4 years. Interventional treatment of Graves disease in the long-term cure rate was 88% (2/2 5), 2 patients were taking antithyroid drugs after surgery, and the other 1 patients relapsed 12 months after surgery, all patients were not found thyroid or Parathyroid dysfunction. Conclusion Interventional treatment of Graves’ disease has better long-term therapeutic effect and is an effective method for clinical treatment of refractory Graves disease.