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目的评价131I与抗甲状腺药物(ATD)治疗儿童和青少年Graves病的疗效。方法取7～16岁儿童和青少年Graves病患者15例,分为131I治疗组8例和ATD治疗组7例,随访2年,观察131I与ATD治疗后疗效、突眼发生率、甲状腺功能低下(甲低)发生率、甲亢复发率及不良反应的情况。结果 131I组治愈6例(6/8),好转1例(1/8),无效1例(1/8);ATD组治愈3例(3/7),好转2例(2/7),无效2例(2/7),两组疗效比较,131I组明显高于ATD组(P<0.01)。治疗后在甲低的发生率131I组高于ATD组(P<0.01);甲亢复发率131I组低于ATD组(P<0.01);发生突眼和对突眼改善的疗效上差异无统计学意义(P>0.01);出现甲亢性心脏病、肝功能受损、白细胞降低等不良反应方面131I组低于ATD组(P<0.01)。结论 131I治疗儿童和青少年Graves病综合疗效优于ATD,是一种疗效肯定、比较安全的方法 。
Objective To evaluate the efficacy of 131I and antithyroid drugs (ATD) in the treatment of Graves’ disease in children and adolescents. Methods Fifteen children with Graves’ disease from 7 to 16 years old and adolescents were divided into three groups: 131I treatment group (n = 8) and ATD treatment group (n = 7). The patients were followed up for 2 years. The therapeutic effect of 131I and ATD was observed. The incidence of exophthalmos and hypothyroidism A low) incidence, recurrence rate of hyperthyroidism and adverse reactions. Results In 131I group, 6 cases (6/8) were cured, 1 case improved (1/8) and 1 case (1/8) failed. In ATD group, 3 cases (3/7) were cured, 2 cases improved (2/7) Invalid 2 cases (2/7), the two groups of curative effect, 131I group was significantly higher than the ATD group (P <0.01). The incidence of hypothyroidism after treatment in 131I group was higher than that in ATD group (P <0.01). The recurrence rate of hyperthyroidism in 131I group was lower than that in ATD group (P <0.01). There was no significant difference between the two groups (P <0.01). In 131I group, the incidence of Hyperthyroid heart disease, impaired liver function and leukopenia were lower than those in ATD group (P <0.01). Conclusion 131I is superior to ATD in the treatment of Graves’ disease in children and adolescents. It is a safe and effective method.