放射性核素131碘治疗老年甲状腺功能亢进症的安全性和有效性

Safety and efficacy of radionuclide 131 iodine in treatment of senile hyperthyroidism

目的探讨131碘对老年甲状腺功能亢进症(甲亢)治疗的安全性和有效性。方法80例老年甲亢患者均分为对照组[常规抗甲状腺药物(ATD)治疗]和观察组(ATD治疗和131碘治疗),均治疗12个月,比较2组患者的治疗效果;分别于治疗前和治疗结束时,采用酶联免疫吸附法检测2组患者的促甲状腺激素(TSH)、游离三碘甲状腺素(FT3)、游离甲状腺素(FT4)、骨钙素(BGP)、碱性磷酸酶(ALP)及β-胶原蛋白(β-CTX)水平;比较治疗期间2组患者的不良反应发生率,比较治疗结束后随访6个月的甲亢复发情况。结果观察组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组患者治疗结束时的血清TSH水平高于对照组,FT3、FT4、BGP、ALP、β-CTX、不良反应发生率及随访6个月甲亢复发率均低于对照组,差异有统计学意义(P<0.05)。结论131碘治疗可改善老年甲亢患者的甲状腺功能和骨代谢异常,药物不良反应较少且不易复发。

Objective To investigate the safety and efficacy of 131 iodine in the treatment of senile hyperthyroidism.Methods Eighty elderly patients with hyperthyroidism were divided into control group[conventional antithyroid drug(ATD)treatment]and observation group(ATD treatment and 131 iodine treatment),compared the treatment effect of 2 groups who were treated for 12 months.The levels of thyrotropin(TSH),free triiodothyronin(FT3),free thyroxine(FT4),osteocalcin(BGP),alkaline phosphatase(ALP),andβ-collagen(β-CTX)were measured by enzyme linked immunosorbent assay(ELISA)before and at the end of treatment,respectively.The incidence of adverse reactions in the two groups during treatment was compared,and the recurrence of hyperthyroidism was compared after 6 months follow-up.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).At the end of treatment,the serum TSH level in the observation group was higher than that in the control group.FT3,FT4,BGP,ALP,β-CTX,incidence of adverse reactions and 6 months follow-up hyperthyroidism recurrence rate were lower than the control group,and the difference was statistically significant(P<0.05).Conclusion Iodine therapy can improve thyroid function and abnormal bone metabolism in elderly patients with hyperthyroidism.