高压氧辅助放射性^(131)I治疗老年甲亢患者疗效分析

Analysis of the curative effect of radioactive ^(131)I therapy assisted by hyperbaric oxygen on elderly patients with hyperthyroidism

目的分析高压氧(HBO)辅助放射性^(131)I在老年甲亢患者治疗中的效果。方法选取2015年1月至2019年12月在河南省商丘市第一人民医院诊治的老年甲亢患者185例,按照治疗方法的不同分为对照组91例和研究组94例,对照组给予放射性^(131)I治疗,研究组在对照组的基础上给予HBO辅助治疗。采用世界卫生组织生存质量测定量表(WHO-QOL)评估生存质量,比较2组的临床疗效、并发症、甲减发生、甲亢复发情况,以及治疗前后的甲状腺激素水平及生存质量。结果研究组的治疗总有效率明显高于对照组(90.43%vs.76.92%,P<0.05)。治疗后2组游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)均降低(P<0.05),且研究组明显低于对照组(P<0.05),治疗后2组促甲状腺素(TSH)均升高(P<0.05),且研究组明显高于对照组(P<0.05)。治疗后2组生理健康、心理状态、个人信仰、社会关系、周围环境、独立能力评分均升高(P<0.05),且研究组明显高于对照组(P<0.05)。研究组与对照组并发症发生率(3.19%vs.5.49%)、甲减发生率(10.64%vs.13.19%)、甲亢复发率(2.13%vs.3.30%)比较,差异均无统计学意义(P>0.05)。结论HBO辅助放射性^(131)I治疗老年甲亢患者,可有效改善甲状腺激素水平,提高生存质量和治疗疗效,且不会增加并发症、甲减发生以及甲亢复发。

Objective To analyze the curative effect of radioactive ^(131)I therapy assisted by hyperbaric oxygen(HBO)on elderly patients with hyperthyroidism.Methods A total of 185 elderly patients with hyperthyroidism diagnosed and treated in the First People’s Hospital of Shangqiu,Henan Province,from January 2015 to December 2019 were divided into control group(91 cases)and experimental group(94 cases)according to different treatment methods.The control group was treated with radioactive ^(131)I,while the experimental group received HBO as an auxiliary treatment on the basis of the treatment of the control group.The World Health Organization Quality of Life Measurement Scale(WHO-QOL)was used to evaluate the quality of life.The clinical efficacy,complications,occurrence of hypothyroidism,recurrence of hyperthyroidism,thyroid hormone levels before and after treatment,and quality of life were compared between the two groups.Results The total effective rate of treatment in the experimental group(90.43%)was significantly higher than that in the control group(76.92%,P<0.05).After treatment,the levels of free triiodothyronine(FT3),free thyroxine(FT4),thyroglobulin autoantibodies(TGAb),and thyroid peroxidase antibodies(TPOAb)all decreased in both groups(P<0.05),and these levels in the experimental group were significantly lower than those in the control group(P<0.05).After treatment,the levels of thyroid stimulating hormone(TSH)in both groups increased(P<0.05),and the level in the experimental group was significantly higher than that in the control group(P<0.05).After treatment,the scores pertaining to physical health,mental state,personal belief,social relationship,environment,and level of independence in the two groups all increased(P<0.05),and the scores in the experimental group were all significantly higher than those in the control group(P<0.05).The incidences of complications(3.19%vs.5.49%)and hypothyroidism(10.64%vs.13.19%),and hyperthyroidism recurrence rates(2.13%vs.3.30%)in both groups were not significantly different from each other(P>0.05).Conclusion HBO-assisted radioactive ^(131)I therapy in elderly patients with hyperthyroidism can effectively increase the level of thyroid hormones,the quality of life,and treatment efficacy,without increasing the incidences of complications and hypothyroidism,and the recurrence of hyperthyroidism.