CAJ | 학술논문

目的：探讨育龄女性甲亢患者碘-131治疗血清性激素变化及其生育情况。方法选取健康志愿者50例、甲状腺功能亢进的育龄女性248例，按治疗方法分为碘-131治疗组和抗甲状腺药物治疗组，3组患者于治疗前和后6个月测定甲状腺功能及性腺激素，并追踪患者受孕和胎儿情况。结果碘-131治疗组较抗甲状腺药物治疗组促甲状腺激素（TSH）水平变化较为敏感；两组患者治疗前促黄体生成素（LH）、促卵泡生成素（FSH）、泌乳素（PRL）、睾酮（T）、孕酮（P）均较对照组明显升高，雌二醇（E2）较对照组降低；碘-131治疗组治疗前后性激素六项变化均有差异，抗甲状腺药物治疗组治疗前后睾酮、孕酮变化不明显；对照组与碘-131治疗组正常分娩率比较差异无统计学意义（χ2＝0．148，P＝0．7＞0．05），对照组与抗甲状腺药物治疗组正常分娩率比较，差异有统计学意义（χ2＝5．739，P＝0．017＜0．05），碘-131治疗组和抗甲状腺药物治疗组正常分娩率比较，差异有统计学意义（χ2＝4．26，P＝0．039＜0．05）。结论碘-131治疗育龄期甲亢妇女未对性激素和生育能力有影响，也未增加遗传损害发生率。
목적：탐토육령녀성갑항환자전-131치료혈청성격소변화급기생육정황。방법선취건강지원자50례、갑상선공능항진적육령녀성248례，안치료방법분위전-131치료조화항갑상선약물치료조，3조환자우치료전화후6개월측정갑상선공능급성선격소，병추종환자수잉화태인정황。결과전-131치료조교항갑상선약물치료조촉갑상선격소（TSH）수평변화교위민감；량조환자치료전촉황체생성소（LH）、촉란포생성소（FSH）、비유소（PRL）、고동（T）、잉동（P）균교대조조명현승고，자이순（E2）교대조조강저；전-131치료조치료전후성격소륙항변화균유차이，항갑상선약물치료조치료전후고동、잉동변화불명현；대조조여전-131치료조정상분면솔비교차이무통계학의의（χ2＝0．148，P＝0．7＞0．05），대조조여항갑상선약물치료조정상분면솔비교，차이유통계학의의（χ2＝5．739，P＝0．017＜0．05），전-131치료조화항갑상선약물치료조정상분면솔비교，차이유통계학의의（χ2＝4．26，P＝0．039＜0．05）。결론전-131치료육령기갑항부녀미대성격소화생육능력유영향，야미증가유전손해발생솔。
Objective To investigate the serum sex hormone changes and fertility condition in childbearing age women patients with hyperthyroidism treated by iodine-131 .Methods 50 cases of healthy volunteers were selected .248 childbearing age women pa-tients with hyperthyroidism were divided into the iodine-131 group and the anti-thyroid medication group according to the treatment method .The thyroid function and gonad hormone before treatment and at 6 months after treatment were detected in 3 groups ,and the pregnancy and fetal condition were tracked .Results The change of thyroid stimulation hormone(TSH) level was more sensitive in the iodine-131 treatment group than the anti-thyroid medication group ;luteinizing hormone(LH) ,follicle stimulation hormone (FSH) ,prolactin(PRL) ,testosterone(T) and progesterone(P) before treatment in the two groups were significantly increased com-pared with the control group ,but E2 was decreased ;the changes of sex hormones in the iodine-131 treatment group had differences between before and after treatment ,the changes of T and P in the anti-thyroid medication group were unobvious before and after treatment ;the normal delivery rate in the control group and the iodine-131 therapy group had no statistical difference (χ2 =0 .148 , P=0 .7>0 .05) ,the normal delivery rate in the control group and the anti-thyroid medication group had statistically significant difference(χ2 = 5 .739 ,P=0 .017<0 .05) ,the normal delivery rate in the iodine-131 therapy group and the anti-thyroid medication group had statistically significant difference(χ2 =4 .26 ,P=0 .039<0 .05) .Conclusion The iodine-131 therapy has no influence on the sex hormones and the fertility ability in childbearing age women patients with hyperthyroidism ,and also does not increase the incidence rate of genetic damage .