探讨碳酸锂联合^(131)I在治疗妇女Graves病的疗效

Efficacy of llithium carbonate combined with ^(131)I in treatment of women Graves disease

目的探讨碳酸锂联合131I在治疗妇女Graves病的疗效。方法 51例女性Graves病患者随机分为研究组(30例)及对照组(21例)。两组均一次性口服131I量;研究组治疗当日开始加服碳酸锂250mg,2次/天,连服4周。检测不同时间的游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平。记录不良反应,随访疗效。结果 131I治疗后15、30、60d,研究组FT3、FT4水平低于对照组(P<0.01)。研究组30、60和90dFT3和FT4较治疗前明显下降;而对照组FT3、FT4较治疗前明显升高。研究组治疗60d时甲状腺大小恢复正常者28例(93.3%),明显多于对照组的11例(52.4%)(P<0.01)。研究组治愈率高于对照组(93.3%vs.57.1%)(P<0.01)。结论碳酸锂联合131I治疗妇女Graves病,能早期降低血清甲状腺激素水平,快速缩小甲状腺,减轻131I治疗的不良反应。

Objective To explore the efficacy of llithium carbonate combined with 131I in treatment of women Graves disease. Methods Fifty-one female patients with Graves disease were randomly divided into two groups of C（21 cases,treated with single oral dose of 131I volume） and A（30 cases, given additional oral lithium carbonate 250mg bid.for 4 weeks）.The free triiodothyronine（FT3）,free thyroxine（FT4） and thyroid stimulating hormone（TSH） were detected on the 15th,30th,and 60th day after 131I treatment.The adverse effects and efficacy were recorded. Results FT3 and FT4 levels were lower in group A than those in group C on the 15th,30th and 60th day after 131I treatment（P0.01）.Compared to before,FT3 and FT4 in group A were significantly decreased on the 30th,60th and 90th day,which were increased in group C（P0.01）. The size of the thyroid returned to the normal on the 60 day in 28 patients（93.3%） of group A,which was higher than 11 patients（52.4%） in group C（P0.01）. The cure rate of group A was higher than that of group C（93.3% vs.57.1%）（P0.01）. Conclusion Llithium carbonate combined with 131I in the treatment of women Graves disease can reduce serum thyroid hormone levels ealy,shrink the thyroid rapidly,attenuate 131I treatment-induced adverse reactions.