抗甲状腺药物治疗Graves病持续时间与复发关系的系统评价

发布时间：2018-03-19 10:37

本文选题：甲状腺功能亢进症　切入点：Graves病　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：背景抗甲状腺药物广泛用于甲状腺功能亢进症的临床治疗,但药物的选择、药物剂量及用药持续时间在临床上目前没有统一标准。目的系统评价抗甲状腺药物治疗Graves病持续时间对疾病复发的影响资料与方法应用计算机检索中英文数据库共7个,包括中国生物医学、万方、中国知网、重庆维普、Cochrane Library databases、PubMed、EMBASE数据库。纳入的文献包括抗甲状腺药物治疗Graves病不同持续时间的随机对照试验研究、前瞻性研究及回顾性病例对照研究。对纳入的文献,两位研究员分别提取数据,数据包括接受抗甲状腺药物治疗的患者人数、药物类型、治疗持续时间、治疗结束随访时间及随访结束复发人数及缓解人数,并对纳入的文献进行质量评分,将分别提取的数据整合,最后使用RevMan5.3软件进行分析。结果共纳入10个文献,1269例Graves病患者。10个研究均报道了抗甲状腺药物治疗Graves病持续时间与短期随访复发的关系,结果显示延长药物治疗的持续时间可改善短期内疾病的复发率,6至12月疗程与18至24月疗程对复发影响比较结果提示长疗程方案疾病短期复发较少,且二者差异有统计学意义(RR0.00001,95%CI[1.33,1.90]),18月至24月疗程与36月至42月疗程对复发影响提示长疗程方案疾病短期复发较少且差异有统计学意义(RR=0.008,95%CI [1.09, 1.81]),对于常规治疗计划及长期小剂量ATD维持治疗对疾病复发影响比较,结果显示对年龄小于35岁的二者无明显差异(OR=0.54,95%CI [0.48,1.46]),但对于年龄大于35岁的结果显示长期小剂量维持疾病缓解率较高,差异有统计学意义(OR=0.006,95%CI[1.17,2.55])。对于长期随访缓解率比较显示,小于等于24月治疗及大于24月治疗二者差异无统计学意义(RR=0.71, 95%CI[0.46,3.17])。结论适当延长抗甲状腺药物治疗Graves病持续时间可改善短期内疾病的复发率。
[Abstract]:Background antithyroid drugs are widely used in the clinical treatment of hyperthyroidism, but the choice of drugs, There is no uniform standard for drug dosage and duration in clinical practice. Objective to evaluate the effect of antithyroid drug therapy on the recurrence of Graves disease and to search 7 databases in Chinese and English by computer. Including China Biomedicine, Wanfang, ChinaNet, Chongqing Weipurn Cochrane Library database PubMMBASE database. The literature included randomized controlled trial studies of different durations of antithyroid drugs for Graves's disease. Prospective studies and retrospective case-control studies. The two researchers extracted data on the included literature, including the number of patients treated with antithyroid drugs, the type of drugs, and the duration of the treatment. At the end of follow-up, the number of relapses and remissions at the end of the follow-up period, and the quality score of the literature included, the collected data were integrated. Finally, RevMan5.3 software was used to analyze the results. Results A total of 1269 patients with Graves's disease were included in 10 literatures. All the 10 studies reported the relationship between the duration of antithyroid drug therapy for Graves's disease and the short-term recurrence of Graves's disease. The results showed that prolonging the duration of drug therapy could improve the recurrence rate of the disease in a short period of time from 6 to December and from 18 to 24 months. The results showed that the short term recurrence rate of long term treatment regimen was less than that of 18 to 24 months treatment. The difference was statistically significant (RR0.00001 ~ 95CI [1.33 / 1.90]). The effects of 18-24 and 36-42 courses of treatment on recurrence were less and the difference was statistically significant. RR0.008 / 95CI [1.09, 1.81] was small for routine treatment plan and long-term treatment. Comparison of the effects of dose ATD maintenance therapy on the recurrence of disease, The results showed that there was no significant difference between the two groups aged less than 35 years old (CI = 0.481.46), but for those older than 35 years old, the remission rate of long-term low-dose maintenance disease was higher, and the difference was statistically significant (P < 0.05). There was no significant difference between the treatment of less than 24 months and that of more than 24 months. Conclusion prolonging the duration of antithyroid drug therapy for Graves disease can improve the recurrence rate of Graves disease in a short period of time.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R581.1

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