儿童Graves’病研究进展

Grave’s病(GD)是导致儿童甲亢最常见的病因,其易感性80%决定于基因因素。ATD治疗是最常推荐的初始治疗手段,但长期缓解率仅为30%。ATD诱导儿童GD缓解的合适用药时间尚不明确。最佳治疗方式(ATD、RAI或手术)的选择还存在重大争议。药物治疗复发的预测非常重要,最近建立了一种复发风险评分,通过种族、年龄、诊断时FT4、TRAb水平、ATD预期治疗持续时间将GD儿童分成低中高三类风险人群,对其复发风险作出评估,对于确定GD儿童在初始治疗时选择何种方案更为适合意义重大。

Advances in Graves＇ Disease in Childhood

Graves＇ disease is the most common cause of hyperthyroidism in children. About 80% of the overall susceptibility to GD is determined by genetic factors. Anti thyroid drug（ATD） treatment is recommended as the initial treatment, but remission is achieved in only 30% after a first course of ATD. The optimal duration of ATD therapy for the induce remis- sion has yet to be estabolished. The most appropriate type of management { ATD or RAI or thyroidectomy）remains one of the key controversies in pediatric endocrinology. How to predict the recurrence of GD after ATD treatment is very important. Recent a prognostic score has been developed, allowing the identification of three different risk groups at diagnosis of childhood GD, defined based on clinical and biological characteristics at diagnosis, which is considerable benefit for patient counseling and for guiding appropriate therapeutic decisions.