目的观察不同剂量甲巯咪唑治疗Graves病的临床疗效,研究治疗前后其雌激素水平变化.方法56例病例随机分为低剂量组(15mg/d,一次口服)和常规剂量组(30mg/d,分3次服),每组各28例.观察治疗治疗3个月后临床疗效及副反应,检测用药前及用药后3个月白血病计数、转氨酶(ALT、AST)水平、甲状腺激素(FT3、FT4)、促甲状腺激素释放激素(TSH)及雌激素(E2)水平,18-24月停药,随访2年复发率.结果治疗3个月后,两组临床疗效无显著性差异(P >0.05),FT3、FT4、TSH及E2水平较治疗前显著性减低(P <0.05),低剂量组副反应发生率较常规剂量组显著性减低(P <0.05),两组随访复发率无差异(P >0.05).结论低剂量给药可以达到治疗Graves病的同时减低副反应发生率,雌激素与Graves病发生具有一定相关性.%Objective To observe clinical efficacy of the different doses of Methimazole for the treatment of Graves' disease, study the estrogen levels changes before and after treatment. Methods 56 cases were randomly divided into the low-dose group(15mg/d. once) and conventional-dose group (30mg/d, three times a service), 28 cases in each group. The clinical efficacy and side effects were observed after treating 3 months, Leukemia count, transaminases(ALT, AST) levels of thyroid hormones(FT3, FT4), thyrotropin releasing hormone(TSH) and estrogen(E2) level were detected before treatment and after 3 months, Withdrawal after of 18-24 months, two-year recurrence rate were followed up. Results After 3 months of treatment, the clinical efficacy was no significant difference(P >0.05). FT3, FT4, TSH and E2 level was significantly decreased(P <0.05), Incidence of side effects of the low-dose group compared with conventional dose group was significantly decreased(P <0.05), and follow-up the recurrence rate of the two groups was no difference(P >0.05). Conclusion Low dose of Methimazole can reduce the incidence of side effects in the treatment of Graves' disease, estrogen with Graves' disease has a certain relevance.
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