超声检查在毒性弥漫性甲状腺肿治疗效果评价中的应用

Application of ultrasound in assessment of treatment effect of diffuse toxic goiter

目的探讨甲状腺超声检查在毒性弥漫性甲状腺肿治疗效果评价中的作用。方法选择80例毒性弥漫性甲状腺肿患者作为研究对象，均给予131I治疗，治疗前后测定血清甲状腺激素水平并进行甲状腺超声检查。结果治疗前和治疗后，游离三碘甲状原氨酸（FT3）水平和血流面积比、血流分级均呈正相关（r=0．472、0．593，均P〈0．05）。治疗后甲状腺重量、收缩期峰值血流速度（PSV）和舒张末期血流速度（EDV）[（12．89±7．86）g、（32．24±21．85）cm／s、（12．36±19．22）cm／s]均明显低于治疗前[（30．12±17．24）g、（68．58±34．25）cm／s、（28．03±21．24）em／s]（t=11．265、4．762、3．672，均P〈0．05）；治疗前后RI和PI比较差异无统计学意义（P〉0．05）。治疗前后甲状腺血流分级比较差异有统计学意义（x2=98．959，P=0．000），治疗前血流分级Ⅲ级比例高（80．0％），治疗后血流分级I级比例高（60．O％）。治疗后Fr，和游离甲状腺素（吼）水平[（6．88±4．14）pmol／L、（17．23±7．35）pmol／L]明显低于治疗前[（18．79±6．45）pmol／L、（56．47±22．97）pmol／L]（t=17．243、13．254，均P〈0．05），促甲状腺素（TSH）水平（11．52±8．27）mU／L明显高于治疗前（0．01±0．00）mU／L（t=3．365，P〈0．05）。治疗后，治愈组甲状腺重量、PSV和EDV[（9．34±2．36）g、（20．13±8．59）cm／s、（9．13±5．34）cm／s]低于未愈组[（18．78±8．76）g、（52．32±13．24）em／s、（17．24±8．34）cm／s]（t=9．143、8．793、5．232，均P〈0．05），治愈组与未愈组RI、PI比较差异无统计学意义（P〉0．05）。结论甲状腺超声检查对毒性弥漫性甲状腺肿131I治疗的效果具有较好的评价作用。

Objective To explore the value of ultrasound in assessment of treatment effect of diffuse toxic goiter. Methods 80 diffuse toxic goiter patients with 131I therapy were selected as research subjects. Before and after treatment, the serum thyroid hormone levels were detected and thyroids were checked by ultrasound. Results Before and after treatment, the FT3 levels were positively correlated with blood flow area ratio and flow grade （ r = 0. 472, 0. 593, all P 〈 0.05 ）. After treatment, the thyroid weight, peak systolic velocity （ PSV ） and end diastolic velocity （EDV） [ （ 12.89 ± 7.86）g, （32.24 ± 21.85 ） cm/s, （ 12.36 ± 19.22 ） cm/s ] were significantly lower than those of before treatment [ （ 30.12 ± 17.24 ） g, （ 68.58 ± 34.25 ） cm/s, （ 28.03 ± 21.24 ） cm/s ] （ t = 11. 265,4. 762,3. 672, all P 〈 0.05 ）. Before and after treatment ,the RI and PI showed no significant difference（ all P 〉 0.05 ）. The difference of thyroid blood flow grade before and after treatment was statistically significant （X2 = 98.959 ,P = 0. 000）, the proportion of flow grade class Ill before treatment was higher（80.0% ） ,while the proportion of flow grade class I after treat- ment was higher（60.0% ）. After treatment, the FT3 and FT4 levels [ （6.88 ± 4.14） pmol/L, （ 17.23 ± 7.35 ） pmol/L ] were significantly lower than those of before treatment [ （ 18.79 ±6.45 ） pmol/L, （56.47 ± 22.97 ） pmol/L ] （ t = 17. 243,13. 254, all P 〈 0.05 ）. The TSH level [ （ 11.52 ± 8.27 ） mU/L ] was significantly higher than that of before treatment [ （0.01 ±0.00） ] mU/L （ t = 3. 365, P 〈 0.05 ）. After treatment, the thyroid weight, PSV and EDV of cure group[ （9.34 ±2.36） g, （20. 13 ± 8.59） cm/s, （9. 13 ±5.34cm/s） ] were lower than those of non - cure group [（18.78±8.76）g,（52.32±3.24）cm/s,（17.24±8.34cm/s）]（t=9.143,8.793,5.232,all P〈0.05）.The differences of RI and PI in the cure group and non - cure group were not statistically significant （ all P 〉 0.05 ）.Conclusion Ultrasound has a better role in the evaluation effect of 131I therapy for diffuse toxic goiter.