D A Koutras, G D Piperingos, D Pallas, K Katsouyanni, K S Karaiskos, P Marafelia, D Makriyannis, J Kitsopanides, J Sfontouris, J Mantzos
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引用次数: 0
摘要
我们单独或联合应用T4、T3和KI治疗地方性无毒甲状腺肿204例。绝对排除结节性甲状腺肿,因为自主性的可能性会增加。在临床治疗前和治疗后6个月采用盲法评估甲状腺肿大,即观察者(总是相同的)既不知道治疗前的甲状腺肿大,也不知道患者接受的治疗。同时记录了各种实验参数。所有的积极治疗(不包括安慰剂)都导致了腺体大小的显著减少。有效性降低的顺序如下:1)T3 50微克/天(最有效),2)(T4 50微克/天+ T3 12.5微克)× 2,3) T4 150微克+碘150微克/天,4)T4 75微克+ T3 18.75微克/天,5)T4 200微克/天,6)T3 37.5微克/天,7)碘300微克/天,8)T4 150微克/天,9)碘150微克/天(最无效),10)安慰剂(无效)。结果表明,T4 200微克和T3 50微克的效果大致相同,略高于300微克的碘化物。考虑到副作用(脉搏率增加,跟腱反射缩短)并没有在重要方面改变疗效的顺序。临床结果总体上与131I摄取抑制(r = 0.220, p = 0.03)和TRH试验(r = 0.248, p = 0.001)相关。(摘要删节250字)
Clinical, laboratory and immunologic effects of the treatment of endemic goiter with T4, T3 and KI.
We treated 204 patients with endemic nontoxic goiter with T4, T3 and KI, singly or in combination. Definitely nodular goiters were excluded, since the possibility of autonomy would be increased. Goiter size was evaluated before and 6 months after treatment clinically in a blind way, i.e. the observer (always the same) did not know either the pretreatment goiter size or the treatment the patient had received. At the same time various laboratory parameters were recorded. All the active treatments (but not placebo) resulted in a highly significant decrease in the gland size. The effectiveness decreased in the following order: 1) T3 50 micrograms/d (most effective), 2) (T4 50 micrograms/d + T3 12.5 micrograms) x 2, 3) T4 150 micrograms + iodide 150 micrograms/d, 4) T4 75 micrograms + T3 18.75 micrograms/d, 5) T4 200 micrograms/d, 6) T3 37.5 micrograms/d, 7) Iodide 300 micrograms/d, 8) T4 150 micrograms/d, 9) Iodide 150 micrograms/d (least effective) and 10) Placebo (not effective). The results show that T4 200 micrograms and T3 50 micrograms are roughly equipotent, and slightly more effective than 300 micrograms of Iodide. Taking into consideration the side effects (increase in pulse rate, shortening of the Achilles tendon reflex) did not change the order of effectiveness in an important way. The clinical outcome correlated in general with the suppression of the 131I uptake (r = 0.220, p = 0.03) and the TRH test (r = 0.248, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)