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Article in Chinese | WPRIM | ID: wpr-869182


Anti-thyroid drug (ATD), radioactive iodine (RAI) and thyroidectomy are treatment options for Graves disease (GD). Treatment strategies for Graves ophthalmopathy (GO) patients include thyroid function control, oral or intravenous corticosteroids, orbital radiotherapy or orbital decompression surgery. However, current treatments for GD and GO are also less ideal because they target the signs and symptoms rather than the pathogenic mechanisms. The development of treatment strategies that targeting the thyroid-stimulating hormone receptor (TSHR) or insulin-like growth factor 1 receptor (IGF-1R) alone or in combination may yield effective and better tolerated treatments for GD and GO. This paper reviews the progress and limitations of the 2 methods.

Article in Chinese | WPRIM | ID: wpr-745885


Objective To investigate the risk factors of atrial fibrillation (AF) in hyperthyroidism patients.Methods The clinical data of 557 patients with hyperthyroidism receiving 131I treatment from January 2015 to May 2018 were enrolled in the study.There were 50 cases with AF and 507 patients without AF before the treatment.Univariate and multivariate logistic regression were applied to analyze the risk factors of AF in hyperthyroidism patients.Results Compareded to non-AF patients,AF patients had older age [(59.1±10.6) vs.(41.9±13.7) years,t=6.75,P<0.01],more males[42.0%(21/50] vs.19.7%(100/507),x2=14.11,P<0.01],longer duration of hyperthyroidism [66.0 (6.8,120.0) vs.12.0(3.0,72.0) months,Z=2.83,P=0.02],higher prevalence of coronary artery disease [16.0%(8/50) vs.2.6%(13/507)] and hypertension[30.0%(15/50) vs.9.3%(47 / 507)],higher serum creatinine (SCr) [51.5(46.0,64.3) vs.42.0(35.0,51.0) μmol / L,Z=4.62,P<0.01],serum uric acid (SUA) [(360.6±90.3) vs.(313.4±80.3)μmol/L,t=3.76,P<0.01]and gamma-glutamy transpeptidase (GGT)[72.1 (38.0,97.0)vs.42.2(17.0,48.8) U/L,Z=4.97,P<0.01] and total bilirubin (TBIL) (21.3±8.8) vs.(13.8±7.7) U/L,t=5.26,P<0.01],direct bilirubin(DBIL)[12.6(7.9,17.4) vs.5.5(4.1,7.9)μmol/L,Z=6.62,P=0.00)]and lower blood platelet (PLT) [(188.5±60.8) × 109/L vs.(241.0±65.1)× 109/L,t=4.52,P<0.01].And there were no significant differences in thyroid hormone level and thyroid autoimmune antibody levels.Univariate and multivariate analysis showed that the age (OR=1.23,95%CI:1.09-1.38,P<0.01),SUA (OR=1.01,95%CI:1.00-1.20,P=-0.05),DBIL (OR=1.65,95%CI:1.01-2.72,P=0.05),GGT (OR=1.04,95%CI:1.01-1.08,P=0.01) were risk factors for AF in patients with hyperthyroidism.Conclusion Older age,abnormal serum SUA,DBIL and GGT are risk factors for atrial fibrillation in patients with hyperthyroidism,to timely control hyperthyroid and to give symptomatic treatment for those patients are necessary.