药物与^(131)I治疗甲状腺功能亢进的临床安全性和医疗经济性对比研究

Comparative study of clinical safety and medical economy between drugs and^(131)I in the treatment of hyperthyroidism

目的探讨药物与放射性核素^(131)I治疗对甲状腺功能亢进患者肝功能和甲状腺功能指标产生的变化及影响,比较两种治疗方法的差异,为临床甲状腺功能亢进治疗方法的选择提供科学依据。方法运用回顾性分析方法,收集并筛选2011-2021年兰州大学第一医院甲状腺功能亢进患者265例。根据治疗方式的不同,将患者分为药物治疗组和^(131)I治疗组,统计分析2组患者治疗前后转氨酶、胆红素、甲状腺激素及抗体等指标。结果药物治疗组甲状腺激素及抗体较治疗前降低,促甲状腺激素较治疗前升高;胆红素较治疗前升高,转氨酶较治疗前降低。^(131)I治疗组甲状腺激素较治疗前降低,促甲状腺激素、甲状腺相关抗体较治疗前升高;转氨酶较治疗前升高,胆红素水平治疗前后无明显变化。结论药物和^(131)I治疗甲状腺功能亢进疗效肯定,药物治疗有明显降低甲状腺抗体水平的作用,^(131)I治疗对胆红素代谢影响较小,后期随访次数少。

Objective To explore the changes in and effects of drug and ^(131)I radionuclide therapy on liver function and thyroid function indexes of patients with hyperthyroidism and compare the differences between the two treatment methods so as to provide a scientific basis for the selection of therapeutic methods for clinical hyperthyroidism.Methods Clinical data of 265 inpatients with hyperthyroidism in the First Hospital of Lanzhou University from 2011 to 2021 were collected and their medical records were analyzed retrospectively.According to the different treatments,patients were divided into a drug treatment group and a ^(131)I radiotherapy group.The indexes of transaminase,bilirubin,thyroid hormone and antibodies were counted before and after treatment.Results The drug treatment group:thyroid hormone and antibody decreased and thyroid stimulating hormone increased.Bilirubin was higher and transaminase was lower compared with these before treatment.In the ^(131)I radiotherapy group thyroid hormone decreased,thyroid stimulating hormone and thyroid related antibody and transaminase were higher compared with those before treatment,and bilirubin level had no significant change before and after treatment.Conclusion The therapeutic effect of drugs and ^(131)I on hyperthyroidism was definite,drug therapy could significantly reduce the thyroid antibody level,^(131)I treatment had little effect on bilirubin metabolism,and less follow-up times were needed,thus saving medical economic resources.