| 江 巍,白盟盟,王海峰,贺 兰,赵 杰.左甲状腺素联合碘131对甲状腺功能亢进症患者甲状腺体积、TR-Ab和TPOAb水平的影响[J].,2020,(7):1305-1308 |
| 左甲状腺素联合碘131对甲状腺功能亢进症患者甲状腺体积、TR-Ab和TPOAb水平的影响 |
| Effects of Levothyroxine Combined with Iodine 131 on Thyroid Volume, TR-Ab and TPOAb Levels in Patients with Hyperthyroidism |
| 投稿时间：2019-11-01 修订日期：2019-11-26 |
| DOI：10.13241/j.cnki.pmb.2020.07.022 |
| 中文关键词: 左甲状腺素 碘131 甲状腺功能亢进症 甲状腺体积 促甲状腺激素受体抗体 甲状腺过氧化物酶抗体 |
| 英文关键词: Levothyroxine Iodine 131 Hyperthyroidism Thyroid volume Thyrotropin receptor antibody Thyroperoxidase antibody |
| 基金项目:内蒙古自治区自然科学基金项目（2017MS(LH)0848） |
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| 中文摘要: |
| 摘要 目的：研究左甲状腺素联合碘131对甲状腺功能亢进症患者甲状腺体积、促甲状腺激素受体抗体（Thyrotropin receptor antibody，TR-Ab）和甲状腺过氧化物酶抗体（Thyroid peroxidase antibody，TPOAb）水平的影响。方法：选择2013年1月-2019年1月我院收治的68例甲状腺功能亢进症患者，随机分为两组。对照组使用小剂量（111～148 MBq）的碘131，观察组在碘131的基础上，联合服用左甲状腺素，每次12.5 μg，每日1次，均治疗3个月后观察疗效及甲状腺体积、TR-Ab和TPOAb水平变化。结果：观察组治疗3个月后的有效率明显高于对照组（P<0.05）；治疗前，两组的甲状腺体积、TR-Ab和TPOAb水平无明显差异（P>0.05），治疗后，两组的上述指标均明显降低（P<0.05），且观察组明显低于对照组（P<0.05）；治疗前，两组的血清游离三碘甲状腺原氨酸（Free triiodothyronine，FT3）、促甲状腺素（Thyroxine，TSH）和游离四碘甲状腺素（Free tetraiodothyroxine，FT4）水平无明显差异（P>0.05），治疗后，两组的血清 FT3和FT4水平明显降低（P<0.05），血清TSH水平明显升高（P<0.05），观察组更加明显（P<0.05）；治疗前，两组的血清甲状腺球蛋白（Thyroglobulin，Tg）和 半胱氨酸蛋白酶抑制剂 C（Cysteine protease inhibitor C，Cys C）水平无明显差异（P>0.05），治疗后，两组的血清Tg和 Cys C水平明显降低（P<0.05），观察组明显低于对照组（P<0.05）。结论：左甲状腺素联合碘131对甲状腺功能亢进症有确切的疗效，能有效阻碍甲状腺自身抗体产生，改善甲状腺功能，降低血清Tg和 Cys C水平。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of levothyroxine combined with iodine 131 on thyroid volume, thyrotropin receptor antibody and thyroid peroxidase antibody levels in patients with hyperthyroidism. Methods: Sixty-eight patients with hyperthyroidism who were admitted to our hospital from January 2013 to January 2019 were randomly divided into two groups. The control group used a small dose (111-148 MBq) of iodine 131, and the observation group based on iodine 131 in combination with levothyroxine, 12.5 μg each time, once a day, both observed the efficacy and thyroid after 3 months of treatment Volume, TR-Ab, and TPOAb levels changed. Results: The effective rate of the observation group after 3 months of treatment was significantly higher than that of the control group (P<0.05). Before treatment, there was no significant difference in thyroid volume, TR-Ab and TPOAb levels between the two groups (P>0.05). After treatment, the thyroid volume, TR-Ab and TPOAb levels of the two groups decreased significantly (P<0.05), while the thyroid volume, TR-Ab and TPOAb levels of the observation group were significantly lower than those of the control group (P<0.05). Before treatment, there was no significant difference in serum FT3, TSH and FT4 levels between the two groups (P>0.05). After treatment, the serum FT3 and FT4 levels of the two groups decreased significantly (P<0.05), and the serum TSH levels increased significantly (P<0.05), especially in the observation group (P<0.05). Before treatment, there was no significant difference in serum Tg and C ys C levels between the two groups (P>0.05). After treatment, the serum Tg and Cys C levels of the two groups decreased significantly (P<0.05), while the serum Tg and Cys C levels of the observation group were significantly lower than those of the control group (P<0.05). Conclusion: Levothyroxine combined with iodine 131 has definite curative effect on hyperthyroidism. It can effectively block the production of thyroid autoantibodies, improve thyroid function and reduce serum Tg and C ys C levels. |
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