^(131)Ⅰ治疗后血清甲状腺激素动态观察

Dynamic Observation on Serum Levels of FT3,FT4,sTSH of Patients with Graves'Hyperthyroidism after ^(131)I Therapy

目的:动态观察131Ⅰ治疗Graves甲亢后1个月内血清甲状腺激素的变化。方法:选择首次明确诊断为Graves甲亢的患者20例,20例均未进行过药物治疗,无合并症和并发症。治疗前1周及治疗后第1周、第2周、第3周、第4周分别检测其血清FT3、FT4、sTSH,分析各项指标的动态变化。结果:131Ⅰ治疗Graves甲亢后1个月内sTSH无明显变化,20例中有15例其血清FT3、FT4水平与治疗前相比呈逐渐下降趋势。5例(5/20)其血清FT3、FT4水平与治疗前相比有所升高(4例轻度升高,1例升高几乎达治疗前2倍),治疗后第2周呈逐渐下降趋势。结论:131Ⅰ治疗Graves甲亢安全有效。大部分未经抗甲药治疗的患者在131Ⅰ治疗后血清甲状腺激素持续下降,少部分患者在治疗后1周可有轻中度升高,其原因有待于进一步研究。

Objective： To dynamically survey the changes of serum levels of FT3, FT4, sTSH of the patients with Graves＇ hyperthyroidism within one month after ^131Ⅰ therapy.Methods： Twenty patients who was first diagnosed as Graves＇ hyperthyroidism were selected. And they were never treated with medicine and no complications and complicating diseases. Their serum levels of FT3, FT4, sTSH were detected before one week of ^131Ⅰ .therapy and after the first, second, third and the fourth week of ^131Ⅰ therapy so as to analyze the dynamic changes of each indexes. Results： All levels of sTSH had no evident changes within one month after Graves＇ hyperthyroidism was treated by ^131Ⅰ therapy and the serum levels of FT3, FT4 of 15 cases among 20 patients presented gradually decreased trend, but the serum levels of FT3, FT4 of 5 cases among 20 patients increased （4 cases slightly increased, 1 case significantly increased, and the increase was nearly twice comparing with before the treatment）, then the 5 cases also presented decreased trend after the treatment of the second week. Conclusions ^131Ⅰ therapy is safe and effective for Graves＇ hyperthyroidism . The majority of patients without using the drugs , their serum thyroid hormones continue decreasing after ^131Ⅰ therapy. While the minority of patients, their serum levels of FT3, FT4 increase slightly or moderately in one week after ^131Ⅰ therapy and the real causes await research.