Thyroid:老年亚临床甲状腺功能亢进症患者放射性碘与长期使用甲巯咪唑疗效比较

2020-08-19 MedSci原创 MedSci原创

RAI和长期低剂量MMI疗法对老年亚临床甲状腺功能亢进症患者均有效且安全。

近日,甲状腺疾病领域权威杂志Thyroid上发表了一篇研究文章,这项研究旨在比较放射性碘(RAI)和长期甲巯咪唑(MMI)治疗老年人亚临床甲状腺功能亢进症的有效性和安全性。

研究人员从306名年龄≥65岁的亚临床甲状腺功能亢进患者中选取了83例TSH<0.1 mU/L的患者纳入研究。在这项随机平行试验中,分别有41名和42名患者随机接受RAI或长期MMI治疗。

在RAI和MMI组中,3例和4例患者因副作用、选择其他治疗方式且未接受随访而被排除在外;两组分别有35名和36名患者完成了60个月的随访。在固定剂量15 mCi RAI治疗60个月后,23名(66%)患者变成甲状腺功能减退患者,12名(34%)患者甲状腺功能仍然正常。在MMI组中,起始剂量为每天10 mg,在连续MMI治疗1年、2年、3年,4年和5年后分别降至4.9±1.0、4.3±1.0、4.4±1.4、4.3±1.8和3.7±1.3mg。研究结束时,通过MMI治疗,34名(94%)患者甲状腺功能正常,2名弥散性甲状腺肿患者发展为自发性甲状腺功能减退症。在治疗的前4个月,两组均发生了轻微不良事件。在随访的60个月内未观察到死亡或严重的副作用。

由此可见,RAI和长期低剂量MMI疗法对老年亚临床甲状腺功能亢进症患者均有效且安全。

原始出处:

Fereidoun Azizi,et al.Treatment of subclinical hyperthyroidism in the elderly: Comparison of radioiodine and long-term methimazole treatment.Thyroid.2020.https://www.liebertpub.com/doi/10.1089/thy.2020.0433

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  5. [GetPortalCommentsPageByObjectIdResponse(id=2010175, encodeId=196620101e519, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Mon May 03 06:18:26 CST 2021, time=2021-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273722, encodeId=980612e3722b4, content=<a href='/topic/show?id=10a5698555f' target=_blank style='color:#2F92EE;'>#甲状腺功能亢进#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69855, encryptionId=10a5698555f, topicName=甲状腺功能亢进)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a19115, createdName=stfoxst, createdTime=Fri Aug 21 07:18:26 CST 2020, time=2020-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324727, encodeId=5b951324e2798, content=<a href='/topic/show?id=1ba1698568b' target=_blank style='color:#2F92EE;'>#甲状腺功能亢进症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69856, encryptionId=1ba1698568b, topicName=甲状腺功能亢进症)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Fri Aug 21 07:18:26 CST 2020, time=2020-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395436, encodeId=91bd139543699, content=<a href='/topic/show?id=504f5e36317' target=_blank style='color:#2F92EE;'>#放射性碘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57363, encryptionId=504f5e36317, topicName=放射性碘)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Fri Aug 21 07:18:26 CST 2020, time=2020-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032619, encodeId=6f0e1032619a2, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Wed Aug 19 19:18:26 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050252, encodeId=0312105025248, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Wed Aug 19 19:18:26 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811120, encodeId=df6581112042, content=挺好, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=749d5411995, createdName=ms6000000169323548, createdTime=Wed Aug 19 18:04:55 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811100, encodeId=7179811100b4, content=挺好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/tFIbqG99ULWomyW3q9TDNWhssrBa1C42kwt9ViaYyFDEZaPsW5uSkpdc5yQ7P9X63kiaRQzMr6durvzUyNNNULBw/132, createdBy=396a2268565, createdName=yumeng0126, createdTime=Wed Aug 19 16:41:40 CST 2020, time=2020-08-19, status=1, ipAttribution=)]
    2020-08-19 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2020-08-19 jingjing

    大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等

    0

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    2020-08-19 ms6000000169323548

    挺好

    0

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    2020-08-19 yumeng0126

    挺好!

    0

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