^(131)Ⅰ治疗甲亢合并糖代谢异常的有效性和安全性

Efficacy and safety of ^(131)Ⅰ in treating hyperthyroidism combined with abnormal glucose metabolism

目的评价131Ⅰ治疗甲状腺功能亢进症(甲亢)合并糖代谢异常的疗效及安全性。方法 108例甲亢合并糖代谢异常患者分为131Ⅰ治疗组55例和抗甲状腺药物(ATD)对照组53例,比较两组甲亢的疗效、血糖、糖化血红蛋白(HbA1c)、胰岛β细胞功能及不良反应。结果治疗组甲亢总有效率显著高于对照组(P=0.008),复发率显著低于对照组(P=0.001),甲状腺功能减退症(甲减)发生率高于对照组(P=0.031),治疗后治疗组的空腹血糖(FPG)、餐后2 h血糖(2hPG)、HbA1c及胰岛素抵抗指数显著低于对照组(P<0.05),胰岛素分泌指数显著高于对照组(P<0.05)。治疗组无其他不良反应,对照组出现糖尿病酮症酸中毒、低血糖等不良反应。结论 131I治疗甲亢合并糖代谢异常疗效好,不良反应少。

Objective To evaluate the efficacy and safety of 131I in treating hyperthyroidism combined with abnormal glucose metabolism.Methods 108 patients with hyperthyroidism combined with abnormal glucose metabolism were divided into 131I group of 55 cases and antithyroid drug（ATD） group of 53 cases as contrast group.Compared the curative effect of hyperthyroidism,blood sugar,glycosylated hemoglobin（HbA1c）,β-cell function and adverse reaction between the two groups.Results The total efficiency of hyperthyroidism in 131I group was obviously higher than that of the contrast group（P=0.008）.The hyperthyroidism recurrence rate of 131I group was evidently much lower than the contrast group（P=0.001）.The occurring rate of hypothyroidism in 131I group was evidently higher than the contrast group（P=0.031）.After treatment,fasting plasma glucose（FPG）,two hour plasma glucose after breakfast（2hPG）,bA1c and HOMA-IR in the 131I group were evidently under than those in the contrast group（P0.05）.HOMA-IS was distinctly higher than that in the contrast group（P0.05）.There was no other adverse reaction in 131I group,while diabetic ketoacidosis,hypoglycemia and other adverse reaction in the contrast group.Conclusion 131I has a good curative effect in treating hyperthyroidism combined with abnormal glucose metabolism,with little adverse reaction.