CAJ | 학술논문

目的分析Graves病患者性别相关的临床特点.方法收集2009年10月至2010年5月在解放军总医院内分泌科门诊就诊的787例Graves病患者临床资料,并按性别进行对比分析.Graves病诊断标准:甲状腺功能亢进(甲亢)同时具有下述2个或多个特征:弥漫性甲状腺肿、甲亢性突眼和促甲状腺激素受体抗体(TRAb)阳性.结果 (1)787例Graves病患者中女性多见,女:男=3.35:1;女性发病年龄更小[(33.20±13.07对36.75±13.89)岁,P=0.002],高峰年龄段明显提前[(20-29对40-49)岁];(2)Graves病常见或少见症状和体征中,男性患者体重减轻、甲亢性心脏病、周期性麻痹和非浸润性突眼更多见,女性则以窦性心动过速和不伴甲亢性突眼更常见、甲状腺弥漫性肿大程度更明显;(3)女性患者血清TT4、FT4、和TRAb水平明显高于男性,其中TRAb显著升高(>30 U/L)者中女性多见,中度升高(10-30U/L)者中则以男性多见;(4)两性患者甲亢家族史无差异,均以母系家族史多见;(5)甲亢治疗预后(问卷调查)显示211例使用抗甲状腺药物治疗至少6个月并停药的患者中复发率为64.3%(137/211),复发率没有性别差异.结论 Graves病临床特点存在明显的性别差异.
목적 분석Graves병환자성별상관적림상특점.방법 수집2009년10월지2010년5월재해방군총의원내분비과문진취진적787례Graves병환자림상자료,병안성별진행대비분석.Graves병진단표준:갑상선공능항진(갑항)동시구유하술2개혹다개특정:미만성갑상선종、갑항성돌안화촉갑상선격소수체항체(TRAb)양성.결과 (1)787례Graves병환자중녀성다견,녀:남=3.35:1;녀성발병년령경소[(33.20±13.07대36.75±13.89)세,P=0.002],고봉년령단명현제전[(20-29대40-49)세];(2)Graves병상견혹소견증상화체정중,남성환자체중감경、갑항성심장병、주기성마비화비침윤성돌안경다견,녀성칙이두성심동과속화불반갑항성돌안경상견、갑상선미만성종대정도경명현;(3)녀성환자혈청TT4、FT4、화TRAb수평명현고우남성,기중TRAb현저승고(>30 U/L)자중녀성다견,중도승고(10-30U/L)자중칙이남성다견;(4)량성환자갑항가족사무차이,균이모계가족사다견;(5)갑항치료예후(문권조사)현시211례사용항갑상선약물치료지소6개월병정약적환자중복발솔위64.3%(137/211),복발솔몰유성별차이.결론 Graves병림상특점존재명현적성별차이.
Objective To investigate the gender-related differences in patients with Graves'disease (GD).Methods Seven hundred and eighty-seven consecutive patients with GD treated with anti-thyroid drug in out-patient clinic of department of endocrinology of Chinese PLA general hospital from Oct.2009 to May 2010 were included in the study.The diagnosis of GD WSB made according to common clinical and laboratory criteria.Results (1)In Graves'disease,a marked female preponderance Was found.The female/male ratio was 3.35:1.Female patients with GD presented at a younger age,compared with males[(33.20±13.07 vs 36.75±13.89)year,P=0.002],and the peak incidences of the disease occurred in female and male were 20-29 years and 40-49 years of age respectively.(2)Male patients presented a higher prevalence of weight loss,thyrotoxic cardiopathy,periodic paralysis,and non-invasive ophthalmopathy whereas tachycardia was more common in females.(3)The females presented larger diffuse goiters with higher serum TT4,FT4,and thyrotropin receptor antibody(TRAb)levels.Cases with TRAb>30 U/L were more common in females,whereas those with TRAb 10-30 U/L were frequently seen in males.(4)There was no gender-related difference in the family history of GD.(5)Remission atleast 6 months after anti-thyroid drug therapy in 211 patients,there was a relapse rate of 64.3%(137/211)without gender difference.Conclusion GD appeared at a younger age and with larger diffuse goiters in females,together with more marked elevation of serum TT4,FT4 and TRAb levels.Altogether,these findings depict different patterns for GD in males and females.