Title Ishodi bolesnika s Gravesovom bolesti u KBC Zagreb Title (english) Treatment outcomes of patients with Graves disease at University Hospital Center Zagreb Author Marina Aust Mentor Tina Dušek (mentor)Committee member Darko Kaštelan (predsjednik povjerenstva)Committee member Jasenka Markeljević (član povjerenstva)Committee member Tina Dušek (član povjerenstva)Granter University of Zagreb Defense date and country 2022-07-15, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Gravesova bolest (GB) je autoimuna bolest štitnjače i najčešći uzrok hipertireoze. Zahvaća populaciju srednje životne dobi i češća je u ženskog spola. Prezentira se simptomima i znakovima poput hiperaktivnosti, razdražljivosti, znojenja, umora, gubitka težine s povećanim apetitom, tahikardije, fibrilacije atrija, tremora i brojnih drugih. Obilježena je i nastankom guše, tireoidne orbitopatije i dermatopatije. Prema europskim smjernicama 1. linija liječenja su tireostatski lijekovi, ali u slučaju da se sa njima ne može postići remisija potrebno je razmotriti i druge modalitete liječenja kao što su radiojodna ablacija i tireoidektomija. Ishod Gravesove bolesti tesko je predvidjeti. Više razine tiroeoidnih hormona i TSH-R-Ab u serumu, veličina guše, mlađa dob, pušenje i orbitopatija su povezani s većim rizikom od relapsa.
Cilj ovoga istraživanja je retrospektivno analizirati kliničke karakteristike i ishod liječenja bolesnika sa Gravesovom bolešću. U istraživanju je sudjelovalo 93 pacijenata s hipertireozom od toga 63 pacijenata s Gravesovom bolešću koji su liječeni u Kliničkom bolničkom centru Zagreb na Zavodu za endokrinologiju. Rezultati su pokazali da su najčešći uzroci hipertireoze Gravesova bolest (68,48%) i toksična multinodularna struma (19,57%). Svi bolesnici s GB su inicijalno liječeni sa tireostatskim lijekovima. Prema našim rezultatima 63,46% pacijenata je bilo u remisiji u 5 godina nakon terapije tireostatskim lijekovima. Najčešći oblik dodatnog tretmana je radiojodna ablacija 15,38%, dok je totalnom tireoidektomijom liječeno ukupno 11,54% pacijenata. Deskriptivnom analizom podataka nije nađena statistički značajna razlika između postizanja remisije tireostatskim lijekovima i razlikom između spola i dobi pacijenata. Prema našim rezultatima prosječne vrijednosti T4 hormona više su u skupinama koji nisu postigli remisiju uz pomoć tireoidnih lijekova.
Abstract (english) Graves' disease (GB) is an autoimmune thyroid disease and the most common cause of hyperthyroidism. It affects the middle-aged population and is more common in women. It presents with symptoms and signs such as hyperactivity, irritability, sweating, fatigue, weight loss with increased appetite, tachycardia, atrial fibrillation, tremors and many others. It is also characterized by the goiter, thyroid orbitopathy and dermatopathy. According to European guidelines, the 1st line of treatment is thyrostatic drugs, but if remission cannot be achieved with them, other treatment modalities such as radioiodine ablation and thyroidectomy should be considered. The outcome of Graves' disease is difficult to predict. Higher serum thyroid hormone and TSH-R-Ab levels, goiter size, younger age, smoking, and orbitopathy are associated with a higher risk of relapse.
The aim of this research is to retrospectively analyze the clinical characteristics and outcome of treatment of patients with Graves' disease. 93 patients with hyperthyroidism participated in the study, of which 63 were patients with Graves' disease who were treated at the Zagreb Clinical Hospital Center at the Department of Endocrinology. The results showed that the most common causes of hyperthyroidism are Graves' disease (68.48%) and toxic multinodular goiter (19.57%). All patients were initially treated with thyrostatic drugs. According to our results, 63.46% of patients were in remission in 5 years after therapy with thyrostatic drugs. The most common form of additional treatment is radioiodine ablation 15.38%, while a total of 11.54% of patients were treated with total thyroidectomy. Descriptive analysis of the data did not reveal a statistically significant difference between the achievement of remission with thyrostatic drugs and the difference between the gender and age of the patients. According to our results, the average values of T4 hormone are higher in the groups that did not achieve remission with the help of thyroid drugs.
Keywords
Gravesova bolest
hipertireoza
tireostatski lijekovi
Keywords (english)
Graves' disease
hyperthyroidism
thyrostatic drug
Language croatian URN:NBN urn:nbn:hr:105:104647 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Repository Dr Med - University of Zagreb School of Medicine Digital Repository Created on 2023-01-02 10:45:09
