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目的 :评价甲状腺局部分别注射免疫抑制剂地塞米松 ( Dex)、环磷酰胺 ( CTX)、环孢素 A ( Cys A)或三药联合治疗甲状腺功能亢进 (甲亢 )的疗效及安全性。方法 :采用随机法将甲亢患者 5 0 0例分为 5组 :Dex、CTX、Cys A治疗组 ,三联治疗组 ,单独口服抗甲状腺药物组 (对照组 )。局部治疗 1次 /周 ,连续 3个月 ,然后每 2周一次共注射 4次 ,再改 1次 /月 ,共 2个月 ,观察甲状腺体积、甲状腺功能、甲状腺自身抗体、肝肾功能及血尿常规改变。结果 :局部注射治疗组甲状腺明显缩小 ,甲状腺激素恢复正常时间明显高于对照组 ,促甲状腺激素受体抗体 ( TRAb)、抗甲状腺球蛋白抗体 ( TGAb)、甲状腺线粒体抗体 ( TMAb)下降速度及程度也较对照组为大 ,以三联药物治疗组疗效最显著。治疗过程中肝、肾功能及血、尿常规无明显改变 ;未观察到明显不良反应 ,亦无甲低及喉返神经损伤。 结论 :免疫抑制剂甲状腺局部注射治疗甲亢疗效显著 ,可推广应用于临床。
Objective: To evaluate the efficacy and safety of local injection of Dex, CTX, Cys A or triple drugs in the treatment of hyperthyroidism (Hyperthyroidism). Methods: Randomly divided 500 cases of hyperthyroidism into 5 groups: Dex, CTX, Cys A treatment group, triple therapy group, single oral anti-thyroid drug group (control group). Local treatment 1 times / week for 3 months, then every 2 weeks for a total of 4 times, and then changed 1 times / month for 2 months, the thyroid volume, thyroid function, thyroid autoantibodies, liver and kidney function and hematuria Routine changes. Results: Thyroid gland was significantly reduced and thyroid hormone returned to normal in the local injection therapy group was significantly higher than that in the control group. The rate and degree of decline of TRAb, TGAb and TMAb decreased significantly Also larger than the control group to triple therapy group the most significant effect. Liver, kidney function and blood, urine routine no significant change in the course of treatment; no obvious adverse reactions, no hypothyroidism and recurrent laryngeal nerve injury. Conclusion: The immunosuppressive thyroid local injection for the treatment of hyperthyroidism has a significant effect and can be widely used in clinic.