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目的探讨甲状腺功能亢进症(甲亢)行131I治疗后出现早发甲状腺功能减退(甲减)及难治性甲亢患者的临床特点。方法回顾性分析单次行131I治疗后3个月内发生甲减的甲亢患者和难治性甲亢患者的相关临床指标,并与同期的对照组患者进行比较分析。结果共纳入246例甲亢患者,早发甲减组甲状腺过氧化物酶抗体(TPOAb)水平高于对照组,差异有统计学意义(P<0.05)。难治性甲亢组病程、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素受体抗体(TRAb)、3h摄碘率、口服131I剂量高于对照组,差异有统计学意义(P<0.05或0.01);促甲状腺激素(TSH)和TPOAb水平低于对照组,差异有统计学意义(P<0.05或0.01)。结论 TPOAb水平与131I治疗后早发甲减关系密切;难治性甲亢患者病程更长,FT3、FT4、TRAb水平更高。
Objective To investigate the clinical features of patients with hypothyroidism (hypothyroidism) and refractory hyperthyroidism after 131I treatment of hyperthyroidism (hyperthyroidism). Methods The clinical data of patients with hyperthyroidism and refractory hyperthyroidism who underwent hypothyroidism within 3 months after 131I treatment were retrospectively analyzed and compared with those of the control group in the same period. Results A total of 246 patients with hyperthyroidism were recruited. The level of thyroid peroxidase antibody (TPOAb) in early hypothyroidism was significantly higher than that in control group (P <0.05). FT3, FT4, TRAb, iodine uptake rate at 3h and oral 131I dose were higher in patients with refractory hyperthyroidism than those in control group (P <0.05 or 0.01). The levels of thyroid stimulating hormone (TSH) and TPOAb were lower than those of the control group (P <0.05 or 0.01). Conclusions TPOAb level is closely related to early hypothyroidism after 131I treatment. Patients with refractory hyperthyroidism have a longer course of disease and higher levels of FT3, FT4 and TRAb.