^(131)I治疗后早发甲减及难治性甲亢患者临床特征分析

Clinical characteristics of patients with early hypothyroidism after ^(131)I therapy and patients with refractory hyperthyroidism

目的探讨甲状腺功能亢进症(甲亢)行131I治疗后出现早发甲状腺功能减退(甲减)及难治性甲亢患者的临床特点。方法回顾性分析单次行131I治疗后3个月内发生甲减的甲亢患者和难治性甲亢患者的相关临床指标,并与同期的对照组患者进行比较分析。结果共纳入246例甲亢患者,早发甲减组甲状腺过氧化物酶抗体(TPOAb)水平高于对照组,差异有统计学意义(P<0.05)。难治性甲亢组病程、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素受体抗体(TRAb)、3h摄碘率、口服131I剂量高于对照组,差异有统计学意义(P<0.05或0.01);促甲状腺激素(TSH)和TPOAb水平低于对照组,差异有统计学意义(P<0.05或0.01)。结论 TPOAb水平与131I治疗后早发甲减关系密切;难治性甲亢患者病程更长,FT3、FT4、TRAb水平更高。

Objective To analyze the clinical characteristics of patients with early hypothyroidism after 131I therapy and patients with refractory hyperthyroidism. Methods The clinical data of patients with early hypothyroidism after receiving 131 I treatment in three months and patients with refractory hyperthyroidism were retrospectively analyzed in the present study, and the clinical data of them were compared with the patients in the control group. Results A total of 246 patients of hyperthyroidism were included. The thyroid peroxidase antibody （TPOAb） level of the early hypothyroidism group was significantly higher than that of the control group （P〈0. 05）. Patients in the refractory hyperthyroidism group had significantly longer disease course and significantly higher levels of free triiodothyronine （FT3）, free thyroxine （FT4）, thyrotrophin receptor antibody （TRAb）, 3 h iodine uptake , and 131I dose compared with the control group （P〈0. 05 or 0. 01 ）; while thyroid stimulating hormone （TSH） and TH）Ab levels of the refractory hyperthyroidism group were significantly lower than those of the control group （P〈0. 05 or 0. 01）. Conclusion TPOAb level is closely related to patients with early hypothyroidism after receiving 131I treatment. Patients with refractory hyperthyroidism have longer disease course and higher levels of FT3, FT4 and TRAb.