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目的:比较硒酵母片联合甲硫咪唑与单用甲硫咪唑治疗Graves病的疗效。方法:180例Graves病患者随机分为A组(甲硫咪唑联合硒酵母片治疗18个月后,继续服用硒酵母片至24个月)和B组(甲硫咪唑联合硒酵母片治疗,疗程18个月)和C组(单用甲硫咪唑治疗,疗程18个月),比较三组患者治疗前3个月的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、高敏促甲状腺激素(sTSH)和促甲状腺激素受体抗体(TRAb)含量变化,治疗3个月时的有效率,以及停用甲硫咪唑6个月后的复发情况。结果:治疗3个月后,3组FT3、FT4、TRAb均较治疗前明显下降(P<0.05),sTSH均明显升高(P<0.05);治疗1、2、3月,A组和B组FT3、FT4和TRAb与C组比较,差异均有统计学意义(P<0.05),但A组与B组比较,差异均无统计学意义(P>0.05)。3组sTSH各时间点间比较,差异均无统计学意义(P>0.05)。治疗3个月时,A组、B组的有效率优于C组(P<0.05);停用甲硫咪唑6个月后3组复发率比较,差异无统计学意义(P>0.05)。结论:硒酵母片可以加快甲巯咪唑治疗Graves病的治疗速度,提高有效率,降低复发率,并且在治疗结束后继续服用硒酵母片有可能预防Graves病的复发。
Objective: To compare the efficacy of selenium yeast tablets combined with methimazole and methimazole alone in the treatment of Graves’ disease. Methods: One hundred and eighty patients with Graves’ disease were randomly divided into group A (metthamycin plus selenium yeast tablets for 18 months, selenium yeast tablets continued for 24 months) and group B (metthamycin combined selenium yeast tablets for treatment 18 months) and group C (treated with methimazole only for 18 months) .Three months before treatment, serum free triiodothyronine (FT3), free thyroxine (FT4) Hypersensitivity to thyroid stimulating hormone (sTSH) and thyrotropin receptor antibody (TRAb) levels, efficacy at 3 months, and relapse after 6 months of discontinuation of methimazole. Results: The levels of FT3, FT4 and TRAb in three groups were significantly decreased (P <0.05) and sTSH were significantly increased after 3 months of treatment (P <0.05). After treatment for 1, 2 and 3 months, There was significant difference between group FT3, FT4 and TRAb and group C (P <0.05), but there was no significant difference between group A and group B (P> 0.05). There were no significant differences in sTSH between the three time points (P> 0.05). At 3 months of treatment, the effective rate of group A and group B was better than that of group C (P <0.05). There was no significant difference in the recurrence rate between the three groups after 6 months of metthamycin withdrawal (P> 0.05). Conclusion: Selenium yeast tablets can speed up the treatment of Graves ’disease with methimazole, improve the efficiency and reduce the recurrence rate, and continue to take selenium yeast tablets after treatment to prevent the possible recurrence of Graves’ disease.