碳酸锂联合^(131)I治疗合并白细胞减少的严重Graves病近期疗效观察

Short-term effect of lithium combined with ^(131)I treatment in serious Graves diseases with granulocytopenia

目的观察碳酸锂联合131I治疗合并白细胞减少的严重Graves病的疗效及安全性。方法在应用升白细胞治疗的基础上,对57例抗甲状腺药物治疗后出现白细胞减少的严重Graves病患者,采用碳酸锂联合131I治疗,观察治疗前、治疗后2周,1、3、6个月的白细胞、体内甲状腺激素[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]变化及治疗后6个月的疗效。结果131I治疗2周及1个月后外周血白细胞与治疗前比较差异无统计学意义(P>0.05),3个月及6个月后外周血白细胞与治疗前比较差异有统计学意义(P<0.01),治疗3个月及6个月细胞明显高于治疗前,患者体内甲状腺激素(FT3、FT4)逐渐下降,与治疗前比较差异均有统计学意义(P<0.01)。6个月后1次治疗痊愈63.1%,甲状腺功能低下发生率15.8%。结论碳酸锂联合131I治疗合并白细胞减少的严重的Graves病安全、有效,在预防甲状腺功能亢进危象的同时能升高白细胞的数量。

Objective To evaluate the short-term efficacy of Lithium and ^13I therapy in serious Graves diseases with grannlocytopenia. Methods A total of 57 patients on serious Graves with granulocytopenia were given Lithium and 131I therapy, the change of the number of leucocyte and thyroid hormone （FT3, FF4） were studied before treatment, 2 weeks, 1 month, 3 months, 6 months after treatment. Results Compared with before treatment ,the nmnber of leucocyte after treatment 2 weeks, 1 month was no significantly change （P〉0.05）, but the number of leucocyte after treatment 3 months, 6 months was significantly increased （P〈0.01）, thyroid hormone （FT3. FT4） after treatment were significandy decreased （P〈0.01）. Conclusion Lithium combined with 131I treatment is highly effective and safe for serious Graves diseases with granulocytopenia.