台灣地區甲狀腺機能亢進治療型態之探討

李帶琪

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台灣地區甲狀腺機能亢進治療型態之探討

A Study on Hyperthyroidism Treatment Patterns in Taiwan

李帶琪 , Masters　　Advisor：林瑞雄　　

繁體中文

全民健保；甲狀腺機能亢進；流行病學；治療型態；醫療利用；臺灣； National Health Insurance ； Hyperthyroidism ； Treatment Patterns ； Epidemiology ； Health Care Utilization ； Taiwan

Abstract │ Reference (53) │ Times Cited (4) │ Altmetrics

Abstract 〈TOP〉

Parallel Abstract 〈TOP〉

This study was intended to explore the treatment and follow-up patterns of hyperthyroidism in Taiwan and compared with guideline standards.Claims data of hyperthyroidism cases of the National Health Research Institute were collected as the data base for analysis during the period 1997 to 2004. The washout duration of new incident treated as hyperthyroidism was 3 years. The subjects who had received anti-thyroid drugs or radioiodine or thyroid operation with the principle diagnosis of hyperthyroidism as the initial treatment of hyperthyroidism between 2000 and 2004 were included in our research. In total, there were 1151 new incident treated hyperthyroidism.
  The annual incidence was 1.2‰ to 1.4‰ from 2000 to 2004. The female incidence was 2.02‰ and male incidence was 0.58‰. Respectively sex ratio was 3.5 : 1. The peak age was 51 to 60 y/o in female and 31-40 y/o and 71-80 y/o in male. Hyperthyroidism was not a rare disease in aged population.
  There were 949 subjects (82%) received antithyroid drug as the first line therapy;202 subjects (17.5%) received thyroid operation as the first line therapy; only 6 subjects (0.5%) received radioiodine as the first line therapy.
   The mean treatment duration with antithyroid drug was 286.5 days in female and 288.5 days in male. Relapse occurred in 42.6% patients during the follow-up period after drug withdraw. Remission analysis revealed that the mean relapse time was 2.6 years and median relapse time was 2.28 years. Compared with the internation treatment guideline , appropriate thyroid function monitoring after medication was found in 48.2% patients and appropriate antithyroid drug treatment duration was found only in 15.7% patients.
The factors associated with appropriate thyroid function follow-up were patient’s age、geographic area and hospital types. The related variables to appropriate medication were patient’s age and proper thyroid function monitor.

Reference ( 53 ) 〈TOP〉

(2002). "American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism." Endocr Pract 8(6): 457-69.
連結：
A.M., S., S. O.P., et al. (1975). "Long-term follow-up results in children and adolescents treated with radioactive iodine(131i) for hyperthyroidism." N Engl J Med 292: 167-71.
連結：
Abraham, P., A. Avenell, et al. (2003). "Antithyroid drug regimen for treating Graves' hyperthyroidism.[update in Cochrane Database Syst Rev. 2004;(2):CD003420; PMID: 15106202]." Cochrane Database of Systematic Reviews(4): CD003420.
連結：
Abraham, P., A. Avenell, et al. (2005). "Antithyroid drug regimen for treating Graves' hyperthyroidism.[update of Cochrane Database Syst Rev. 2004;(2):CD003420; PMID: 15106202]." Cochrane Database of Systematic Reviews(2): CD003420.
連結：
Allannic, H., R. Fauchet, et al. (1990). "Antithyroid drugs and Graves' disease: a prospective randomized evaluation of the efficacy of treatment duration." J Clin Endocrinol Metab 70(3): 675-9.
連結：

Times Cited (4) 〈TOP〉

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