단일 갑상선 결절에 대한 갑상선 호르몬 투여 효과에 대하여

Abstract

To evaluate the efficacy of thyroid hormone suppressive therpy and the hormonal characteristics during suppressive therapy for solitary thyroid nodule, we measured plasma T3, T4, TSH concentration and thyroid volume by high-resolution ultrasonography in 42 patients with benign solitary nodule proved by fine-needle aspiration biopsy before and after treatment. After suppressive therapy, TSH stimulation testing was done.Forty-two patients were randomized to receive the comthyroid treatment (group A, n=24) or a placebo (group B, n=18). The duration of therapy was between 3 and 6 months.The results were as follows: 1) The clinical characteristics showed no significant differences between group A and group B. 2) Forty-two patients had 131I scintiscans. Two patients as functional nodule, 10 patients as hypofunctional nodule, 30 patients as nonfunctional nodule.3) After thyroid hormone suppressive therapy, plasma TSH concentrations were lower in group A (1.7±0.8 uU/ml) than in those of group B (7.0±3.8 uU/ml) as shown by the TRH stimulation test (p<0.0001).4) Before and after treatment, the maximal dimension and volume of the thyroid nodules showed no significant differences between group A and group B (p>0.05). After treatment, there were significant decrement in those of group A (p<0.05) and only the maximal dimension in group B (p<0.05).Therefore we concluded that the efficacy of thyroid hormone suppressive therapy in reducing the size of solitary thyroid nodules is not apparent sithin 3 to 6 months, despite effective suppression of thyrotropin. (J Kor Soc Endocrinol 7:39~45, 1992)