Graves病抗甲状腺药治疗后^(131)碘再治疗的效果

Effect of ^(131)Iodine Retreatment after Antithyroid Drugs Treatment in Graves'Disease

目的探究毒性弥漫性甲状腺肿(Graves病)抗甲状腺药治疗后^(131)碘再治疗的效果。方法选择汕头市中心医院核医学科2019年10月至2022年10月收治的80例Graves病患者为研究对象,计算机随机分为研究组、对照组,各40例,对照组给予抗甲状腺药治疗,研究组给予抗甲状腺药+^(131)碘治疗,对比两组临床疗效、疾病复发情况、甲减发生情况、并发症发生率、甲状腺激素水平以及甲状腺肿大好转情况。结果研究组治疗总有效率高于对照组治疗有效率(90.00%vs.70.00%,χ^(2)=5.000,P<0.05);研究组复发率低于对照组(7.50%vs.27.50%),甲减发生率高于对照组(20.00%vs.5.00%,χ^(2)=5.541、4.114,均P<0.05);研究组血象降低、肝功能损伤、甲亢性心脏发生率低于对照组(7.50%vs.27.50%,χ^(2)=5.541,P<0.05);治疗前两组甲状腺激素水平差异不显著,而治疗后研究组TT4、FT4低于对照组,TSH水平高于对照组,差异有显著性(t=34.392、4.724、5.492,P<0.05);治疗后,两组患者甲状腺肿大情况均有所好转,且研究组好转情况高于对照组,于6、12个月比较时存在统计学意义(χ^(2)=18.337、6.270,均P<0.05)。结论Graves病抗甲状腺药联合^(131)碘治疗能够有效提升疾病治疗效果,对降低疾病复发,改善患者甲状腺激素水平,促进甲状腺肿好转有显著价值。

Objective To investigate the efficacy of^(131)iodine retreatment for toxic diffuse goiter(Graves'disease)after antithyroid therapy.Methods A total of 80 patients with Graves'disease admitted to department of nuclear medicine Shantou Central Hospital from October 2019 to October 2022 were selected as the study subjects.The patients were randomly divided into study group and control group,with 40 patients in each group.The control group received antithyroid drug therapy,and the study group received antithyroid drug+^(131)iodine therapy.The clinical efficacy,disease recurrence,hypothyroidism,complication rate,thyroid hormone level and improvement of goiter were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group(90.00%vs.70.00%,χ^(2)=5.000,P<0.05).The recurrence of rate of the study group was lower than that of the control group(20.00%vs.5.00%,χ^(2)=5.541,4.114,all P<0.05).The incidence of blood pattern reduction,liver function injury and hyperthyroidism in the study group were lower than that in the control group(7.50%vs.27.50%,χ^(2)=5.541,P<0.05).Before treatment,the differences in thyroid hormone levels between the two groups could be ignored,after treatment,TT4 and FT4 in the research group were lower than those in the control group,while TSH levels were higher than those in the control group(t=34.392,4.724,5.492,all P<0.05).After treatment,goiter was improved in both groups,and the improvement in the study group was higher than that in the control group,with statistical significance at 6 and 12 months(χ^(2)=18.337,6.270,P<0.05).Conclusion Retreatment of Graves'disease with ^(131)iodine after treatment with antithyroid drugs can effectively improve the therapeutic effect of Graves'disease,and has significant value in reducing disease recurrence,improving thyroid hormone levels and promoting the improvement of goiter.