^(131)I治疗Graves病后的暂时性甲状腺功能低下因素

Clinical Analysis of the Distinguish Factors of Transient Hypothyroidism Occurring in Patients with Graves Disease After ^(131)I Treatment

目的通过随访Graves病131I治疗后发生早发甲低的患者,并按其转归分为暂时性甲低和永久性甲低两组,回顾性分析两组患者在行左旋甲状腺素替代治疗前后的一些相关指标的差异,加以对比,以此对Graves病131I治疗后发生暂时性甲低的患者加以判别,及时确定转归方向,指导临床治疗。方法收集31例Graves病行131I治疗后发生早发甲低的患者的一般资料、实验室检查(FT3、FT4、TSH、TPO、TGA)、甲状腺摄131I率,并分别随访1年确定患者的甲低类型。结果①应用t检验分析显示,暂时性甲低组与永久性甲低组间患者年龄、服131I总剂量、早发甲低出现时间、FT3、FT4、TSH、TPO、TGA各项指标差别不具有统计学意义;②暂时性甲低组与永久性甲低组间患者的摄131I率经t检验分析示两者差异有显著性,具有统计学意义。结论131I治疗Graves病后发生早发甲低的患者行左旋甲状腺素替代治疗前测得的摄131I率的不同值对暂时性甲低的判定起到重要的参考作用。

Objective Follow up the early hypothyroidism patients and divided them into the tmnsient hypothyroidism and the permanent hypothyroidism according to their turnover. And make a retrospective analysis of the correlated factors before Euthyroxin, then contrast the factors between the two groups, in order to induce the difference which related with the transient type of the early hypothyroidism, then definite the tendency of turnover, guide the clinical treatment. Methods The information of 31 ^131I treated patients with Graves＇ disease was collected including general data, laboratory data, ^131I uptake, then follow up for one year to find out the type of the hypothyroidism. Results T- test showed that the clinical observation such as age, total ^131I dose, the emergence time of hypothyroidism and the laboratory data such as FT3,FT4,TSH,TGA,TPO have no statistical significance. T test showed that the ^131I uptake rate has statistical significance. Conclusions The ^131I uptake rate before prior substitution therapy after the RAI affect the distinguish of the hypothyroidism type.