Graves甲亢患者^(131)I治疗后甲减发生情况及与血清TGAb、TPOAb的关系

Occurrence of hypothyroidism and its relationship with serum TGAb and TPOAb in patients with Gravesdisease after ^(131)I treatment

目的 探讨Graves甲亢(GD)患者^(131)I治疗后甲减发生情况及与血清抗甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)的关系。方法 选取2021年1月至2023年1月于四川省乐山市井研县人民医院就诊的72例行^(131)I治疗GD患者的临床资料进行研究。收集患者信息,根据患者治疗前TGAb、TPOAb水平是否阳性(任意一项≥60 U/mL即为抗体阳性)分为阳性组(n=42)与阴性组(n=30)。比较两组一般资料、血清指标、甲减发生率,采用Logistic回归分析GD患者^(131)I治疗后血清TGAb、TPOAb水平与甲减发生的相关性。结果 阳性组患者治疗前及治疗后TGAb、TPAOb水平均高于阴性组患者,差异有统计学意义(P<0.05);阴性组患者治疗后TGAb、TPAOb水平均高于治疗前,差异有统计学意义(P<0.05)。阳性组甲减发生率为40.28%,高于阴性组的16.67%,差异有统计学意义(P<0.05)。多因素Logistic分析显示,^(131)I治疗后血清TGAb≥60 U/mL、TPOAb≥60 U/mL是发生甲减的独立危险因素(P<0.05)。结论 GD患者抗体、血清TGAb、血清TPOAb检测具有重要指导意义,可作为早期评估GD患者甲减发生风险的标志物,指导临床治疗方案制定。

Objective To explore the occurrence of hypothyroidism and its relationship with anti-thyroglobulin antibody(TGAb)and thyroid peroxidase antibody(TPOAb)in patients with Gravesdisease(GD)after ^(131)I treatment.Methods The clinical data were collected from 72 patients with GD who underwent ^(131)I treatment at Jingyan County People’s Hospital between January 2021 and January 2023.According to pres-ence or absence of TGAb and TPOAb positive before treatment(either≥60 U/mL:antibody positive),patients were divided into a positive group(n=42)and a negative group(n=30).The general data,serum in-dexes and incidence of hypothyroidism were compared between the two groups.The correlation between serum TGAb,TPOAb levels and hypothyroidism in GD patients after ^(131)I treatment was analyzed by logistic regres-sion analysis.Results Before and after treatment,levels of TGAb and TPAOb in the positive group were higher than those in the negative group,and the difference was statistically significant(P<0.05).After treat-ment,levels of TGAb and TPAOb increased in the negative group,the difference was statistically significant(P<0.05).The incidence of hypothyroidism in the positive group was higher than that in the negative group(40.28%vs 16.67%),the difference was statistically significant(P<0.05).Multivariate logistic analysis showed that serum TGAb≥60 U/mL and TPOAb≥60 U/mL after ^(131)I treatment were independent risk factors for hypothyroidism(P<0.05).Conclusion The detection of antibodies,serum TGAb and serum TPOAb is of great significance in GD patients.The three indexes can be applied as early assessment markers for the risk of hypothyroidism and can help guide the development of clinical treatment regimens for GD patients.