甲亢^(131)I治疗干预后甲状腺功能状态与血清PTH水平的相关性分析

A Study of the Effect of Iodine-131 Therapy on the Treatment of Hyperthyroidism and the Association Between Thyroid Function and Serum PTH Level

目的探讨甲亢^(131)I治疗干预后甲状腺功能状态以及与血清PTH水平的相关性。方法选取本院接受^(131)I治疗的甲亢患者60例,同时选取接受常规药物治疗的甲亢患者65例为对照组。随访近期和较远期治疗效果。患者均知情同意并签署知情同意书。统计分析采用卡方检验以及t检验等完成,SPSS1 7.0统计软件包用于数据分析。结果两组患者治疗后TT_3水平均有下降;^(131)I治疗组治疗后1周TT_3水平显著低于治疗前,治疗后3个月继续平稳下降;TT_4水平变化与TT_3变化趋势近似。经治疗1周,^(131)I治疗组TT_3和基础代谢率水平明显低于对照组,P<0.01;治疗后3个月TT_3、TT_4以及基础代谢率水平均明显低于对照组,P<0.01。且^(131)I治疗组治疗后3个月痊愈率显著高于对照组,P<0.01。好转率在治疗后1周可见^(131)I治疗组显著高于对照组。对甲状旁腺激素水平的影响分析可见,^(131)I治疗组PTH水平治疗后1周水平升高,治疗3个月继续回升,P<0.01。而对照组PTH水平治疗后3个月才开始回升。总有效率的比较结果则提示治疗组1周和后3个月的总有效率均显著高于对照组,差异均有统计学意义。结论 ^(131)I治疗干预后甲状腺功能状态恢复快效果好,具有一定临床优势,且甲亢进展与血清PTH水平成负反馈作用,治疗效果可以通过PTH水平回升得到佐证。

Objective To investigate the effects of hyperthyroidism Iodine-131 therapy on hyperthyroidism and the association between thyroid function and serum PTH level. Methods Sixty patients with hyperthyroidism treated with 131I were recruited and 65 patients received the drug therapy as controls. The Follow-up of the short-term and long-term treatment effects were compared. All patients signed informed consent. Statistical analysis using chi-square test and t test were conducted, SPSSIT. 0 statistical software package was used for data analysis. Results The level of TT3 decreased after treatment in both groups. The level of TT3 in 131I treatment group was significantly lower than that before treatment and remained stable after 3 months of treatment. TT4 level and TT3 had the similar trend. The TT3 and basal metabolic rate were significantly lower in the 131I treatment group than those in the control group（P 〈0. 01 ）, while the levels of TT3, TT4 and basal metabolic rate were significantly lower than those in the control group after 3 months of treatment （P 〈 0.01 ）. 131I treatment group cure rate was significantly higher than the control group after three months,P 〈 0.01. The improvement rate was significantly higher in the 131I treatment group than in the control group after one week of treatment. （ P 〈 0.01 ）. The level of PTH in 131I treatment group increased after one week of treatment, and continued to rise after three months of treatment, P 〈 0.01. While the control group PTH levels began to show the recovery after three months. The total efficiency of the comparison results suggested that the total effective rate of treatment group with one week and three months were significantly higher than the control group. Conclusion Thyroid function recovery after 131I treatment of hyperthyroidism has negative feedback effects on serum PTH level. The therapeutic effect can beconfirmed by PTH level recovery.