^131I治疗男性甲状腺亢进症周期性麻痹的临床观察：与抗甲状腺药物治疗比较

Clinical evaluation of the treatment in male patient with thyrotoxic periodic paralysis：^131I treatment compared with antithyroid drug therapy

目的评价^131I治疗男性甲状腺功能亢进症（甲亢）周期性麻痹的临床疗效。方法100例已确诊的男性甲亢周期性麻痹病例，分成^131I治疗组（50例）和抗甲状腺药物（ATD）治疗组（50例），分别治疗后随访3年，比较两组的治疗疗效、甲状腺功能减退症（甲减）发生率、甲亢周期性麻痹的复发率及治疗的副反应（粒细胞减低、肝功能受损、药源性皮疹的发生）。结果^131I治疗组治疗总有效率为80％，高于ATD治疗组（52％），二者差异有极显著性（x^2=8．73，P〈0．01）；^131I治疗组甲亢周期性麻痹的复发率及副反应的发生均明显低于ATD治疗组（x^2=18．92，P〈0．01；x^2=11．11，P〈0．01）；但^131I治疗组的甲减发生率高于ATD治疗组（x^2=6．35，P〈0．05）。结论^131I治疗明显优于传统的ATD治疗，能有效控制男性甲亢周期性麻痹的反复发作，且用药安全，副反应少。

Objective To evaluate clinical efficacy of ^131I treatment for thyrotoxic periodic paralysis. Methods 100 male patients with thyrotoxic periodic paralysis were divided equally into two groups, and treated with ^131I or antithyroid drugs （ATD）. They were followed up regularly for 3 years with the cure rate, the incidence of hypothyroidism, the recurrence rate of thyrotoxic periodic paralysis and the side effects, which included granulocytopenia, liver function damage and skin rash from medicinal herbs resource. Results The cui＇e rate of ^131I therapy and ATD therapy for thyrotoxic periodic paralysis is 80% and 52%, respectively. And there is significant difference between them （ x^2=8.73,P〈0.01）. The group of ATD therapy has a higher recurrence rate of thyrotoxic periodic paralysis and more side effects （x^2=18.92, P 〈 0.01 ;x^2=11.11, P〈0.01）. While the group of ^131I therapy has a higher incidence of hypothyroidism （x^2= 6.35, P〈0.01）. Conclusions ^131I is preferable to effectively control the recurrent attacks of thyrotoxic periodic paralysis.