CAJ | 학술논문

目的：探讨131 I治疗对育龄期女性Graves病患者生育能力的影响，并比较两种方法治疗甲亢患者后与正常人群妊娠结局及不孕症发病率的差异性，正确选择治疗方法。方法选择2006年1月～2011年12月育龄女性经131 I治疗的育龄期甲亢患者188例为131 I治疗组，门诊随机选择120例抗甲状腺药物（ ATD）患者为药物治疗组，门诊随机抽出200例育龄期女性生育情况作为对照组。对两治疗组病例至少治疗6个月后FT3，FT4恢复正常、TSH大致正常方能妊娠，对其妊娠成功率、妊娠结局、甲亢合并不孕症的生育情况、出生婴儿畸形率进行综合性统计分析。结果131 I组中成功生育人数162例（86．2％），与ATD组（89．2％）比较，差异无显著性（χ2＝0．595，P＞0．01），两种治疗方法在生育率及妊娠结局方面与正常对照组均无显著性差异，出生胎儿131 I治疗组畸形率1．23％，ATD治疗组0．93％（χ2＝0．053，P＞0．01）。但甲亢合并不孕症131 I治疗后生育成功率均高于ATD治疗组（χ2＝3．9 P＜0．01）。131 I治疗组正常分娩率为90．2％，ATD治疗组89．7％，二组正常分娩率无明显差异。结论育龄期女性Graves病患者选择131 I治疗对其生育能力无明显影响，且131 I治疗方法高效、快捷，能最大可能减少对心、肝、骨髓等脏器功能的损害，亦能减少ATD药物对胎儿的影响，对优生优育有重要意义。
목적：탐토131 I치료대육령기녀성Graves병환자생육능력적영향，병비교량충방법치료갑항환자후여정상인군임신결국급불잉증발병솔적차이성，정학선택치료방법。방법선택2006년1월～2011년12월육령녀성경131 I치료적육령기갑항환자188례위131 I치료조，문진수궤선택120례항갑상선약물（ ATD）환자위약물치료조，문진수궤추출200례육령기녀성생육정황작위대조조。대량치료조병례지소치료6개월후FT3，FT4회복정상、TSH대치정상방능임신，대기임신성공솔、임신결국、갑항합병불잉증적생육정황、출생영인기형솔진행종합성통계분석。결과131 I조중성공생육인수162례（86．2％），여ATD조（89．2％）비교，차이무현저성（χ2＝0．595，P＞0．01），량충치료방법재생육솔급임신결국방면여정상대조조균무현저성차이，출생태인131 I치료조기형솔1．23％，ATD치료조0．93％（χ2＝0．053，P＞0．01）。단갑항합병불잉증131 I치료후생육성공솔균고우ATD치료조（χ2＝3．9 P＜0．01）。131 I치료조정상분면솔위90．2％，ATD치료조89．7％，이조정상분면솔무명현차이。결론육령기녀성Graves병환자선택131 I치료대기생육능력무명현영향，차131 I치료방법고효、쾌첩，능최대가능감소대심、간、골수등장기공능적손해，역능감소ATD약물대태인적영향，대우생우육유중요의의。
Objective To investigate its effect on the fertility of 131 I in the treatment of women of childbearing age in patients with Graves disease ,and to explore the difference of two methods in the treatment of patients with hyperthyroidism and normal pregnancy out -come and the incidence of infertility ,the women of childbearing age of GD patients with scientific attitude ,choose the most suitable treatment for their correct.Methods From January 2006 to December 2011,188 women of childbearing age with hyperthyroidism after 131 I therapy were enrolled as 131 I treated group ,120 cases of outpatients receiving anti thyroid drug ( ATD) as drug therapy group ,200 cases of outpatients in childbearing age fertility as control group .The treatment groups received treatments ,at least 6 months,until FT3,FT4 returning to normal, TSH being roughly normal for pregnancy .The pregnancy rate ,pregnancy ,hyperthyroidism complicated with infertility fertility ,birth deformities were statistically analyzed.Results The number of 131I group with the reproductive success was 162 cases(86.2%).Compared with 89.2%in the ATD group,the difference had no statistical significance (χ2 =0.595,P>0.01),the fetal malformation rate in 131I treatment group was 1.23%,ATD group 0.93%(χ2 =0.053,P>0.01),two had no significant difference.But after 131I treatment,reproductive success rate a-mong hyperthyroidism complicated with infertility subjects was higher than that in the ATD group (χ2 =3.9,P<0.01).Normal delivery rate in 131 I group was 90.2%,ATD group 89.7%,and two groups had no significant difference .Conclusion 131 I treatment of women in child-bearing age with Graves disease has not effect on fertility .131 I treatment method is efficient ,fast,and can maximize the possibilities to reduce damage to the heart,liver,bone marrow and other organs function ,also can reduce the effect of ATD drugs on the fetus ,which has important significance to improve prenatal and postnatal care .