Analysis Of Related Factors In Refractory Graves’ Disease With After Anti-Thyroid Drug Treatment

Objective To retrospectively analyze the clinical data of patients with Graves’ s disease treated with anti-thyroid drug(ATD),and to observe the influencing factors of clinical factors on the treatment results of GD patients.Methods A total of 389 GD patients treated with ATD in-out patients clinical of department of endocrinology of the second affiliated hospital of Chongqing medical university from September 2016 to September 2018 were included in the present study.Patients were divided into non-refractory group(n = 127)and refractory group(n = 262)according to the treatment results of ATD.The general clinical features and thyroid related indexes of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the related factors affecting the results of antithyroid drug therapy.Results(1)Overall,Patients included 83 males(median 38 years,range 26-52years)and 306 females(median 34 years,range 26-46years).Compared with the non-refractory group,the levels of serum FT3,FT4,TRAb,smoking,family history of hyperthyroidism and the rate of goiter in the refractory group were significantly higher(P<0.05).After treatment,the course of treatment,iodine limitation rate,serum TSH level and TRAb level in refractory GD group were significantly different from those in non-refractory GD group(P<0.05).(2)Multivariate Logistic regression analysis showed that newly diagnosed TRAb(OR=3.651,P < 0.05),family history of hyperthyroidism(OR=2.503,P<0.05),unrestricted iodine(OR=1.700,P< 0.05),goiter(OR=1.186,P<0.05),newly diagnosed FT4 level(OR=1.016,P<0.05),smoking(OR=1.046,P<0.05)was the related factor of refractory GD.(3)ROC curve showed that TRAb≥10 IU/L,the remission rate decreased.Conclusions There are various clinical factors related to the discontinuation of ATD.Males had a lower remission rate.TRAb level,goiter,high thyroid hormone level,unrestricted iodine intake,smoking and family history may be related factors for the prolongation of treatment course.Reducing iodine intake and quitting smoking during treatment may improve the remission of GD.There was no relationship between the kind of drugs and the outcome of L-T4 treatment.