Graves病^(131)I治疗前后Ghrelin及胰岛素样生长因子-1的变化及临床意义

Change and clinical significance of Ghrelin and IGF-1 in patients with Graves disease before and after ^(131)I treatment

目的探讨不同剂量^(131)I治疗Graves病前后Ghrelin及胰岛素样生长因子-1(IGF-1)的变化及临床意义。方法选取2013年1~12月收治的54例Graves病患者及同期的40例健康体检者作为研究对象。将Graves病患者分为小剂量组、大剂量组,各27例,健康体检者作为对照组。小剂量组口服^(131)I溶液2.60~2.95 MBq/g甲状腺组织,大剂量组给予口服^(131)I溶液3.69~4.41 MBq/g甲状腺组织。比较各组治疗前后的Ghrelin、IGF-1水平及血清FT3、FT4、TSH含量,记录两组的甲状腺功能减退发生率及甲状腺功能亢进复发率。结果小剂量组、大剂量组治疗前的IGF-1、FT3、FT4水平显著高于对照组,TSH、Ghrelin水平低于对照组,差异有统计学意义(P<0.05)。小剂量组治疗后的FT3、FT4、IGF-1水平低于大剂量组,TSH、Ghrelin水平高于大剂量组,差异有统计学意义(P<0.05)。Person相关性分析结果显示,Graves病患者的Ghrelin与IGF-1表达呈负相关(r=-0.548,P<0.05)。两组的甲状腺功能减退发生率比较,差异无统计学意义(P>0.05)。小剂量组的复发率低于大剂量组,差异有统计学意义(P<0.05)。结论小剂量^(131)I治疗Graves病的临床疗效确切,复发率低,值得推荐。

Objective To explore the change and clinical significance of Ghrelin and insulin like growth factor-1 （IGF- 1） in patients with Graves disease before and after treatment with different doses of ^131I.Methods 54 cases patients with Graves disease and 40 cases of healthy physical examination from January 2013 to December were selected.The patients with Graves disease were divided into the low dose group and the high dose group,27 cases in each group.The healthy persons were selected as the control group.The patients in the low dose group were treated with 131I of 2.60- 2.95 MBq/g,while the patients in the high dose group were given ^131I of 3.69-4.41 MBq/g treatment.The serum Ghrelin and IGF-1 level and serum FT3,FT4,TSH content before and after treatment in the two groups was compared.The incidence rate of hypothyroidism and recurrence rate in the two groups was recorded.Results The level of FT3,FT4,IGF-lbefore treatment in the low dose group and the high dose group was higher than that in the control group,the level of TSH, Ghrelin before treatment in the low dose group and the high dose group was lower than that in the control group,with significant difference （P〈0.05）.The level of FT3,FT4,IGF-1 after treatment in the low dose group was lower than tha in the high dose group after treatment,the level of the TSH,Ghrelin after treatment in the low dose group was higher than that in the high dose group after treatment,with significant difference （P〈0.05）.The result of Person correlation analysis showed that the expression of Ghrelin and IGF-1 was negatively correlated with expression in patients with Grave disease（r=0.548,P〈0.05）.There was no significant difference in the incidence rate of hypothyroidism between the two groups （P〉0.05）.The recurrence rate in the low dose group was lower than that in the higher dose group,with significant difference （P〈0.05）.Conclusion Low dose 131I in the treatment of Graves disease is effective and accurate,and the recurrence rate is low.h is worth recommending.