抗甲状腺药物治疗Graves病复发风险因素及预测模型的研究进展  

Advances in research on anti-thyroid drugs for recurrence risk factors and predictive models of Graves′disease

作　　者：周鹏[1] 赵月婷 陈国芳[1] 刘超[1] Zhou Peng;Zhao Yueting;Chen Guofang;Liu Chao(Key Laboratory of Syndrome&Treatment of Yingbing of State Administration of Traditional Chinese Medicine,Department of Endocrinology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing,210028)

机构地区：[1]南京中医药大学附属中西医结合医院内分泌科,国家中医药管理局瘿病证治重点研究室,南京210028

出　　处：《中华内分泌代谢杂志》2019年第12期1068-1072,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81800756、81471010)。

摘　　要：Graves病又称弥漫性毒性甲状腺肿,是一种伴甲状腺激素分泌增多的自身免疫性疾病。抗甲状腺药物(anti-thyroid drug,ATD)、放射性碘和甲状腺切除术是Graves病的3种有效治疗措施。通常情况下,ATD是国内医师首选的Graves病治疗方案,但较高的复发率一直是ATD治疗的短板。复发主要与性别、年龄、吸烟、病程、甲状腺肿大程度等因素有关。其中,单个风险因素在评估ATD治疗后Graves病复发概率中的可靠性和应用性较差,多因素综合评分的预测模型有助于初发患者选择最佳治疗方案,达到精准治疗、提高Graves病药物治疗缓解率的目标。本文就近年来影响ATD治疗后Graves病复发风险因素的可靠性进行评估,并针对Graves病治疗后复发事件(GREAT)评分、GREAT+评分、临床严重程度评分(CSS)等预测模型的建立及应用研究进展进行综述。Graves′disease,also known as diffuse toxic goiter,is an autoimmune disease with increased secretion of thyroid hormone.There are three effective treatments for Graves′disease,which including anti-thyroid drugs(ATD),radioactive iodine and thyroidectomy.In general,ATD is the first choice of Graves′disease treatment for domestic physicians,but the high recurrence rate has always been the deficiency of ATD treatment.Recurrence is mainly related to gender,age,smoking,course of disease,goiter and other factors.Among them,the reliability and applicability of single risk factor in evaluating the recurrence rate of Graves′disease after ATD treatment are poor.The prediction model of multi-factor comprehensive score is helpful for the naive patients to choose the best treatment plan,to achieve the goal of precise treatment and to improve the remission rate of Graves′disease drug treatment.In this paper,the reliability of risk factors for Graves′disease recurrence after ATD treatment is evaluated,and the development and application of prediction models such as Graves′recurrent events after therapy(GREAT)score,GREAT+score,and clinical severity score(CSS)are reviewed.

关 键 词：抗甲状腺药物 格雷夫斯病复发 风险因素 预测模型 

分 类 号：R5[医药卫生—内科学]