Abstract：Objective To compare the therapeutic effect of methimazole 15 mg/d and 30 mg/d for thyrotoxic Graves’ disease and to observe adverse reactions among newly diagnosed patients of this disease. MethodsTwo hundred and forty-five cases of Graves disease were randomly assigned to two therapy groups in a prospective study. Each patient in Group A(n=135) was given 15mg methimazole once daily in the morning while Group B(n=110) was given 10 mg methimazole three times a day. A follow-up study followed methimazole treatment at different initial dosages among all the participants. The remission rate and frequency of adverse effects were measured after 4, 8 and 12 weeks of treatment.Results (1)The rate of compliance with methimazole was 91.9% in Group A, which was significantly higher than 80.9% in Group B. (2) No remarkable difference of efficiency in normalizing FT4 and FT3 was observed between the two groups at the 4th, 8th and 12th week (62.1%, 83.6% and 89.7% in Group A compared with 65.9%, 84.4% and 88.3% in Group B). (3) The incidence of adverse reactions was 5.9% in Group A and 10.9% in Group B. (4)Thyroid enlargement of Ⅲ degree(OR=12.529) or four-time increase of serum FT4(OR=9.117)was a risk factor that influenced the treatment outcome of 15 mg methimazole once a day.Conclusions In the initial treatment ofg thyrotoxic Graves’ disease, 15 mg methimazole once a day is safe and effective for most patients, but for cases with thyroid enlargement of Ⅲ degree or significant elevation of thyroid hormone,10 mg methimazole three times a day is preferable.
戴红, 吴蕾, 徐丽君, 崔屹, 宋宇, 栗偲平, 朱红霞, 贺威, 马英, 佟珊珊, 王雪, 崔娟红. 不同起始剂量甲巯咪唑治疗Graves病的疗效[J]. 武警医学, 2017, 28(10): 977-979.
DAI Hong, WU Lei, XU Lijun, CUI Yi, SONG Yu, LI Siping, ZHU Hongxia, HE Wei, MA Ying, TONG Shanshan, WANG Xue, CUI Juanhong. Initial treatment of thyrotoxic Graves’ disease with methimazole at different dosages. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(10): 977-979.
Sundaresh V, Brito JP, Wang Z, et al . Comparative effectiveness of therapies for Graves’ hyperthyroidism: a systermatic review and network neta-analysis[J]. J Clin Endocrinol Metab, 2013,98(9):3167-3677.
Nakamura H, Miyauchi A, Miyawaki N, et al . Analysis of 754 cases of antithyroid drug-indruced agranulocytosis over 30 years in Japan [J]. J Clin Endocrinol Metab, 2013,98(12):4776-4783.
[6]
Tsuboi K, Ueshiba H, Shimojo M, et al . The relation of initial methimazole dose to the incidence of methimazole-induced agranulocytosis in patients with Graves’ disease[J]. Endocr J,2007 ,54(1):39-43.
2017, Vol. 28 
