低剂量^(131)I对Graves病患者血清Ghrelin水平及相关血清学指标的影响研究

The study of low doses ^(131)I on serum levels of ghrelin and related serological indexes in patients with grave′s disease

目的探讨低剂量131I对毒性弥漫性甲状腺肿(Graves病)患者血清Ghrelin水平及相关甲状腺血清学指标的影响。方法采用随机对照试验的方法,收集该院2011年6月至2012年6月收治确诊的Graves病甲状腺功能亢进症患者96例及同期健康体检者42例。将甲状腺功能亢进症患者分为A、B组,每组48例,健康体检者为对照组。A组患者给予131I溶液3.69~4.40MBq/g治疗,B组给予131I溶液2.59~2.96 MBq/g治疗,3个月后对两组患者治疗前后血清Ghrelin水平及甲状腺相关血清学指标进行统计学比较分析。2年随访,复查血清Ghrelin水平及甲状腺相关血清学指标并比较统计甲减发生率。结果 A、B组患者血清游离甲状腺素3(FT3)、FT4及空腹血糖(FPG)水平均显著高于对照组(P<0.01),血清超敏甲状腺素(S-TSH)及Ghrelin水平明显低于对照组(P<0.01)。治疗后3个月,B组血清FT3、FT4及FPG水平均显著低于A组,差异有统计学意义(P<0.05);血清S-TSH及Ghrelin水平明显高于A组,差异有统计学意义(P<0.05)。随访2年,B组甲状腺功能减退发生率低于A组,但差异无统计学意义(P>0.05)。结论相对低剂量131I溶液治疗Graves病,疗效更确切,近期甲状腺功能减退发生率更低。

Objective To investigate the low doses of 131 iodine on serum Ghrelin levels and serological related indexes in patients with hyperthyroid. Methods A randomized controlled trials, 96 cases of hyperthyroidism in our hospital were randomly divid- ed into two groups （group A and group B） according to the ratio of 1 ： 1 from June 2011 to June 2012,48 cases in each group,and at the same time,42 cases health people as health control group. The group A were treated with 131 iodine solution 3.69-4.40 MBq/g reatment,group B was given 131 iodine solution 2.59-2.96 MBq/g treatment, and the serum Ghrelin levels and serological related indicators of two groups patients were statistically analyzed after treatment. Followed up for 2 years, review of the serum levels of Ghrelin and serological related indexes and compare the incidence of hypothyroidism. Results The serum FT3,FT4 and FPG levels of hyperthyroid patients were significantly higher than the health control group （P〈0. 01） ; conversely, the serum S- TSH and Ghrelin levels of hyperthyroid patients were significantly lower than the health control group （P〈0.01）. 3 months later after treatment,the serum FT3, FT4 and FPG levels of the hyperthyroidism group B were significantly lower than：hyperthyroidism group A（P〈0.05） ;on the contrary, the serum Ghrelin and S-TSH levels were significantly higher and hyperthyroidism group A （P〈0.05） ;2-year follow-up after treatment,the incidence of hypothyroidism of hyperthyroidism group A were higher and group B,but without statistical significance（P〈0.05）. Conclusion A low dose of oral 131 iodine solution （2.59-2.96 MBq/g） ,could get a better short-term efficacy in patients with hyperthyroidism,high security.