自身免疫性甲亢131碘治疗后不同时期患者血清中TPO Ab水平的研究

Research on the level of serum TPO-Ab in patients with autoimmune hyperthyroidism after treatment of ^(131)I

目的对自身免疫性甲亢病人进行131I治疗并进行随访,以探讨治疗后不同时期患者血清中TPO-Ab水平变化。方法 184例患者131I治疗后进行随访,并选择我院健康体检者为对照,观察治疗后1、3、6及12个月疗效和血清FT3、FT4、sTSH及TPO-Ab变化情况。结果随着131I治疗后时间延长,甲功正常者逐渐增多,治疗12个月后,甲功正常者101例(55.19%),甲减50例(27.62%),未治愈32例(17.49%),总治疗有效率82.51%,与治疗1、3、6个月有明显区别(χ2=9.158,P=0.000);治疗后FT3水平逐渐下降,但直到治疗12个月后,184例患者FT3平均水平仍高于正常对照,差异有统计学意义(P<0.05);FT4水平逐渐下降,在治疗3个月时仍高于对照(P<0.05),但在治疗6个月时与对照相比差异无统计学意义(P>0.05);治疗后sTSH水平逐渐升高,在治疗12个月后与正常对照差异无统计学意义(P>0.05);治疗1个月后TOP-Ab水平仍较高,且与其他时间段差异有统计学意义(P<0.05),治疗3个月、6个月和12个月TOP-Ab水平仍高于正常对照,但互相之间差异无统计学意义(P>0.05)。结论 131I治疗后FT4水平恢复较快,sTSH次之,FT3改善最慢,血清TPO-Ab水平有变化但变化不明显。

To explore the changes of serum TPO-Ab levels in autoimmune hyperthyroidism patients treated with 131I, total of 184 patients were treated with 131I and were followed up, with 32 healthy individuals as control, whose serum FT3, FT4, sTSH and TPO-Ab levels were detected and compared at 1 month, 3 months, 6 months and 12 months after the treatment. We found that along with the time after 131I treatment, more patients showed normal thyroid function： 12 months after the treatment, 101 patients demonstrated normal thyroid function （55.19%）, while 50 cases showed hypothyroidism （27.62%） and 32 cases were not cured （17.49%）, the total effective rate was 82.51%, which was statistically different with before （X2=9.158, P=0.000）; FT3 level decreased gradually after treatment, but still higher than that of normal control （P〈 0.05）; the level of FT4 decreased gradually from month 3 post treatment, and showed no significant difference with that of control group （P 〉 0.05） at month 6; sTSH level increased gradually after treatment, and reached the level of control at month 12 post treatment （P 〉 0.05）; one month after treatment, the TPO-Ab level was still higher than that of control （/9〈 0.05）, but at month 3, month 6 and month 12 post-treatment, the level of TPO-Ab showed no statistical difference with that of control （P〉 0.05）. Take together, after 131I treatment, FT4 levels restore fast. then sTSH and FT3; TPO-Ab level changes but no obvious.