甲状腺机能亢进的治疗

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甲状腺机能亢进(甲亢)可用抗甲状腺药物、β-受体阻滞剂、放射碘和手术治疗。不同疗法各有其优缺点。药物治疗,方便而安全,但缓解率低,且易复发。放射碘和手术治疗虽缓解率较高,但易引起甲状腺机能减退症(甲减)等并发症。所以,治疗前必须慎重选择治疗方案,以求得到满意效果。一、硫脲类抗甲状腺药物治疗 40岁以下的弥漫性甲状腺肿伴甲亢的病人,首选硫脲类抗甲状腺药物治疗。这类药物通过阻止T_3、T_4合成而发挥其作用。尽管甲基和丙基硫氧嘧啶具有甲亢平、他巴唑相同的效力,但目前使用最广泛的是后二者。因为,近来有人指出甲亢平和他巴唑有以下免疫作用:①减少甲状腺淋巴细胞浸润;②抑制甲状腺自身抗体产生;③减低血浆中甲状腺微粒体抗体水平;④减低血浆中甲状腺刺激免疫球蛋白水平。 Hyperthyroidism (hyperthyroidism) available antithyroid drugs, beta-blockers, radioactive iodine and surgery. Different therapies have their own advantages and disadvantages. Drug treatment, convenient and safe, but the relief rate is low, and easy to relapse. Although radioactive iodine and surgical treatment of high response rate, but can easily lead to hypothyroidism (hypothyroidism) and other complications. Therefore, before treatment must be carefully selected treatment options, in order to be satisfied with the results. First, thiourea antithyroid drugs in patients under 40 years of diffuse goiter with hyperthyroidism, the preferred thioureas anti-thyroid drug treatment. These drugs play a role by blocking T_3, T_4 synthesis. Although methyl and propylthiouracil have hyperthyroidism, methimazole has the same potency, but the two most widely used are the latter. Because, recently, it was pointed out that hyperthyroidism and methimazole have the following immunological effects: ① reduce thyroid lymphocyte infiltration; ② inhibit the production of thyroid autoantibodies; ③ reduce plasma thyroid microsomal antibody levels; ④ reduce thyroid stimulating plasma immunoglobulin levels.
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