131I联合甲巯咪唑对甲状腺功能亢进症患者TRAb、TGAb及骨密度的影响

The effects of 131I combined with methimazole on the levels of TRAb,TGAb and bone mineral density in patients with hyperthyroidism

目的观察131I联合甲巯咪唑对甲状腺功能亢进症患者促甲状腺素受体抗体(TRAb)、抗甲状腺球蛋白抗体(TGAb)水平及骨密度的影响。方法选取2017年6月至2018年6月收治的甲状腺功能亢进症患者116例,随机分为研究组与对照组,每组58例。对照组患者给予甲巯咪唑片治疗,研究组患者给以甲巯咪唑片联合131I治疗。检测2组患者甲状腺功能指标[游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、血清促甲状腺素(TSH)、TRAb、TGAb、过氧化物酶抗体(TPOAb)]、骨代谢指标[骨钙素(BGP)、降钙素(CT)、β-胶原蛋白(β-CTx)、总I型前胶原N端肽(PINP)以及腰椎2~4、髋部、股骨颈骨密度。结果研究组近期治疗总有效率为96.55%,显著高于对照组的72.41%,差异有统计学意义(P<0.01)。治疗后,2组患者FT3、FT4、TRAb、TGAb、TPOAb、BGP、CT、β-CTx及PINP水平均降低,TSH水平、腰椎2-4、髋部、股骨颈密度上升,且研究组改善情况优于对照组,差异均有统计学意义(P<0.05)。结论 131I联合甲巯咪唑治疗甲状腺功能亢进疗效显著,可有效控制甲状腺激素水平,降低TRAb和TGAb水平,改善骨密度。

Objective To observe the effects of 131I combined with methimazole on the levels of TRAb,TGAb and bone mineral density in patients with hyperthyroidism. Methods A total of 116 patients with hyperthyroidism who were admitted and treated in our hospital from June 2016 to June 2018 were randomly divided into research group and control group,with 58 cases in each group. The patients in control group were treated by methimazole,however,thepatients in research group were treated by methimazole combined with 131I.The thyroid function indexes including FT3, FT4, TSH, TRAb, TGAb and TPOAb, and bone metabolism indexes including BGP,CT,β-CTx and PINP, and lumbar vertebrae 2-4, hip and femoral neck bone density were observed and compared between the two groups.Results The recent total effective rate in research group was 96.55%,which was significantly higher than that(72.41%) in control group(P<0.01). After treatment,the levels of FT3, FT4, TRAb, TGAb, TPOAb, BGP, CT,β-CTx and PINP were decreased in both groups, while the levels of TSH, lumbar 2-4, hip and femoral neck density were increased, and the improvement degree in research group was superior to that in control group(P<0.05).Conclusion The therapeutic effects of 131I combined with methimazole on hyperthyroidism are significant,which can effectively control thyroid hormone levels, reduce TRAb and TGAb levels, and improve bone density of patients.