^(131)I治疗Graves病血清指标动态分析

Dynamic Monitoring of Serum Markers After ^(131)I Radiotherapy in Patients of Graves' Disease

目的分析在Graves病131I治疗中血清指标动态监测的应用价值。方法 350例Graves病患者分别于131I治疗前及治疗后3,6,9和12个月测定血清TRAb、FT3、FT4、TSH、TGAb及TMAb水平,与135名健康对照者比较。将治疗前与对照组、治疗后3个月与治疗前的血清指标进行比较。结果患者组血清TRAb、FT3、FT4、TGAb和TMAb的水平治疗前明显均高于健康对照组(P<0.01),治疗后3个月明显低于治疗前(P<0.01),治疗后6个月直至12个月均逐渐下降。治疗前的TSH水平明显低于健康对照组(P<0.01),治疗后3月直至12个月逐渐升高。治疗后不同时间点与对照组比较,TRAb、FT3和FT4,3个指标分别在12个月、6个月和9个月恢复正常。结论血清指标动态监测有助于Graves病的诊断和131I治疗后的随访监测和疗效评价。

Objective To explore the clinical value of dynamic monitoring of serum markers after ^131I radiotherapy in patients of Graves＇ disease. Methods The serum levels of TRAb, FT3, FT4, TSH, TGAb and TMAb in 350 patients with Graves＇ disease and 135 normal controls were measured before and at 3, 6, 9 and 12 months after 1311 radiotherapy. Results The serum levels of TRAb, FF3, FT4, TGAb and TMAb in Graves＇ disease group before treatment was obviously higher than that of control group （35.80 ± 1.02 vs 6.81 ±2. 10, 18.86±3.40 vs 10.10±2.13, 41.64±7.82 vs 18.10±5.88, 31.24±4.12 vs 1.98±2.10 and 32.10±5.02 vs 2.98 ±1.18）.The serum levels of above markers at 3 months after treatment were obviously lower than that of before treatment （P 〈0.01 ）, and these markers were gradual declined from 6 months to 12 months. The TSH levels before treat- ment in Graves＇ disease group were obviously lower than that of control group （ 1.85 ± 1.12 vs 7.54 ±3.02, P 〈 0.01 ）, and it gradual rose from 6 months to 12 months. In comparison of serum markers between different time points after treatment and control group, time to achieve normality of TRAb, FT3 and FT4 were 12 months, 6 months and 9 months respectively. Conclusion Dynamic monitoring of serum markers might have clinical signifi- cance in the diagnosis of Graves＇ disease and in the monitoring and efficacy evaluation of 131I radiotherapy.