(A) study on therapeutic effect of antithyroid agents in graves' disease
Authors
허미
Issue Date
1985
Description
의학과/석사
Abstract
[한글]
Graves병의 치료방법에는 여러 가지가 있으나 모두 항진된 갑상선 기능을 억제하여 정상 기능을 유지시키는데 있다. Graves 병의 치료법으로는 항갑상선제는 비교적 널리 사용되고 있으며, 갑상선호르몬의 생산 및 분비작용을 억제할 뿐 아니라 면역억제 작용도 있다는 보고도 있다. (Alexander 등, 1973 : Slingerland 등, 1976) Graves 병 치료는 항갑상선제로 조절이 가능하나 영구적 관해율이 바교적 낮기 때문에 일부 환자들은 처음부터 수술이나 방사성 동위원소 치료를 받기도 하는데, 불완전 수술이나 불가변의 갑상선기능저하증이 초래되기도하여 (Dunn등, 1964 : Green 등 1964)초기 치료시는 항갑상선제를 사용하는 추세이다. 그러나 치료기간에 대해서는 많은 논란이 되어왔다.
저자는 1978년 1월부터 1984년 7월까지 연세의대부속 세브란스병원 내과에서 Graves 병으로 진단된 환자 69예를 대상으로 항갑상선제의 치료기간에 따라, 단기군, 중기군, 및 장기군으로 나누어 임상 및 내분비학적 검사로 치료효과를 관찰하여 다음과 같은 결과를 얻었다.
and 24 hours I131 uptake rate were not correlated with remission rate.
In conclusion short-term therapy with antithyroid agent in Graves' disease might
be effective in the patients with initial small thyroid size and low serum T3 level
.
[영문]
Although it has been repeatedly noted that Graves' disease may be self-limited, antithyroid drugs have been used for limited peiods to control the disease. Because the rate of permanent remission with antithyroid drug was relatively low with decreased tendency and there is no certain usual means of predicting remission, the
duration of such therapy is arbitrary.
Sixty nine patients with Graves' disease were evaluated clinically and endocrinologically with grouping of short-term, and long-term at Yonsei University Severance Hospital during past 7 years.
1. Male to female ratio was 1:6.7 and age distribution was peak in 3rd and 4th decades.
2. Mean durations of treatment were 3.8±0.4 month in short-term group, 8.1±0.2 months in intermediate-term and 14.8±0.7 months in long-term group.
3. Intervals to relapse were 4.1±0.6 (0.5-6.0) months in short-term group, 5.2±0.1 (1.0-7.5) months in intermediate-term group and 4.8±0.9 (1.0-10.0) months in long-term group.
4. Follow up periods were 10.7±1.3 (6.0-32.0) months in short-term group, 11.9±1.1 (9.5-41.5) months in intermediate-term group and 22.1±2.5 (6.0-21.0) months in long-term group.
5. Remission rate was 57.1% in short-term group, 57.1% in intermediate-term group and 40% in long-term group and was not different with statistical significance in each group.
6. The thyroid weight was lighter and the serum T3 level was lower in remission group than in relapse grop in short-term group with statistical significance.
7. Serum T4 level, serum T3/T4 ratio, serum antimicrosomal antimicrosomal titer and 24 hours I131 uptake rate were not correlated with remission rate.
In conclusion short-term therapy with antithyroid agent in Graves' disease might be effective in the patients with initial small thyroid size and low serum T3 level.