Comparison of oral prednisone and intrathyroidal injection of dexamethasone in treatment of patients with subacute thyroiditis / 第二军医大学学报

ABSTRACT

Objective:To compare efficacy and time course of adrenocortical function recovery of oral prednisone and intrathyroidal injection of dexamethasone in patients with subacute thyroiditis. Methods: Sixty patients with subacute thyroiditis were divided randomly into 2 groups. Patients in group Dex (30 cases) were treated with intrathyroidal injection of dexamethasone (5 mg,twice per week,and then once per week.). Patients in group Pre (30 cases) were treated with prednisone. Prednisone was orally given in decreasing doses: 30 mg for the first 2 weeks, 20 mg for 2 weeks, thereafter the dose was tapered by 5 mg per week. Clinical outcomes of 2 groups were compared after 2 weeks, 4 weeks,6 weeks and 8 weeks of treatment. Rapid corticotropin stimulation test was used to assess adrenocortical function. A positive response, indicative of normal adrenocortical function,has been defined as a 30 min stimulated cortisol level of more than 552 nmol/L.The initial stimulation test was performed as a baseline study immediately following the diagnosis of subacute thyroiditis,before the initiation of glucocorticoid therapies. The tests were repeated 24 h after completion of glucocorticoid course and 2 weeks and every 4 weeks thereafter until a stimulated cortisol level of more than 552 nmol/L was achieved. Results: Curative rate of group Dex and group Pre after 8 weeks were 100% and 90% respectively. Duration of therapy was (5.7?2.0) weeks in group Dex and (8.8?1.8) weeks in group Pre respectively ( P