个 甲状腺功能亢进症的治疗 南方医科大学珠江医院内分泌科程彦臻副主任医师 Department of Endocrinology Zhujiang Hospital Southern Medical University
甲状腺功能亢进症的治疗 南方医科大学珠江医院内分泌科 程彦臻 副主任医师 Department of Endocrinology Zhujiang Hospital Southern Medical University
General management(一般治疗) 个 ·No iodine intake Energy and nutrients supplement ·Rest enough Avoid heavy physical labour Sedatives for restlessness and insomnia. 还a
General management（一般治疗） • No iodine intake • Energy and nutrients supplement • Rest enough • Avoid heavy physical labour • Sedatives for restlessness and insomnia
Management临床治疗 Three principal therapies are available for hyperthyroidism Antithyroid Agents Radioactive iodine Subtotal thyroidectomy 抗甲亢药物 放射性碘 甲状腺次全切除术
Management 临床治疗 Antithyroid Agents 抗甲亢药物 Radioactive iodine 放射性碘 Subtotal thyroidectomy 甲状腺次全切除术 Three principal therapies are available for hyperthyroidism
Antithyroid Drugs(ATD)抗甲状腺药物 Class Summary: ■Thiourea(疏脲类)：Propylthiouracil(PTU,丙硫氧嘧啶) ■Imidazoles(咪唑类)：carbimazole(卡比马唑，甲亢平)，thiamazole(甲巯咪唑，他巴唑) ■Mechanism: They principally inhibit the function of TPO,reducing iodide organification and coupling processes,thereby preventing synthesis of thyroid hormones. They also reduce thyroid antibody levels. .Inhibits deiodination(脱碘)ofT4toT3
■ Class Summary： ■ Thiourea (硫脲类）：Propylthiouracil（ PTU，丙硫氧嘧啶） ■ Imidazoles（咪唑类）：carbimazole(卡比马唑,甲亢平）, thiamazole( 甲巯咪唑,他巴唑） ■ Mechanism： ■ They principally inhibit the function of TPO, reducing iodide organification and coupling processes, thereby preventing synthesis of thyroid hormones. ■ They also reduce thyroid antibody levels. ■ Inhibits deiodination（脱碘）of T4 to T3 Antithyroid Drugs（ATD）抗甲状腺药物
Antithyroid Drugs(ATD)抗甲状腺药物 个 ·Dosage and course---back-titration regimen(逐渐减量方式) 初治期--维持期 p1 st stage(ca.4~8wks):治疗期 full dosage to control symptoms PTU:50-150 mg,Bid or Tid MMI:10-30 mg,Qd p3 rd stage(ca12~18mon)：维持期 When serum thyroid hormone levels are normal PTU 50-100mg,Bid or Tid MMI 5-10mg Qd
• Dosage and course------back-titration regimen( 逐渐减量方式) 初治期---维持期 p 1st stage (ca.4~8 wks)：治疗期 full dosage to control symptoms PTU: 50-150 mg, Bid or Tid MMI: 10-30 mg，Qd p 3rd stage (ca 12~18 mon) ：维持期 When serum thyroid hormone levels are normal PTU 50-100mg, Bid or Tid MMI 5-10mg Qd Antithyroid Drugs（ATD）抗甲状腺药物