国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2014年
2期
90-93
,共4页
格雷夫斯病%肝%近距离放射疗法%碘放射性同位素
格雷伕斯病%肝%近距離放射療法%碘放射性同位素
격뢰부사병%간%근거리방사요법%전방사성동위소
Graves disease%Liver%Brachytherapy%Iodine radioisotopes
目的 观察131I治疗Graves病合并肝损害患者的甲状腺激素水平和肝功能各项指标的变化,评价131I治疗的临床效果,为临床提供实践性指导.方法 回顾性分析101例接受131I治疗的Graves病合并肝损害患者的临床资料,对治疗前和治疗后3、6个月甲状腺激素水平和肝功能各项指标的变化进行分析.结果 患者经过131I治疗后6个月,甲状腺功能恢复正常者79例,明显好转者14例,甲状腺功能减退者8例;肝功能恢复正常者94例,好转者7例.131I治疗后3个月和6个月,所有患者甲状腺激素水平明显降低,TSH逐渐恢复,丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、碱性磷酸酶、γ-谷氨酰转移酶和总胆红素水平显著下降;治疗后3个月与治疗前、治疗后6个月与治疗后3个月甲状腺激素水平和肝功能各项指标分别进行比较,差异均有统计学意义(t=4.609～26.865,P均＜0.01).结论 对于Graves病合并肝损害患者,131I治疗优于抗甲状腺药物治疗,当临床确诊Graves病合并肝损害时应首选131I治疗.
目的 觀察131I治療Graves病閤併肝損害患者的甲狀腺激素水平和肝功能各項指標的變化,評價131I治療的臨床效果,為臨床提供實踐性指導.方法 迴顧性分析101例接受131I治療的Graves病閤併肝損害患者的臨床資料,對治療前和治療後3、6箇月甲狀腺激素水平和肝功能各項指標的變化進行分析.結果 患者經過131I治療後6箇月,甲狀腺功能恢複正常者79例,明顯好轉者14例,甲狀腺功能減退者8例;肝功能恢複正常者94例,好轉者7例.131I治療後3箇月和6箇月,所有患者甲狀腺激素水平明顯降低,TSH逐漸恢複,丙氨痠氨基轉移酶、天門鼕氨痠氨基轉移酶、堿性燐痠酶、γ-穀氨酰轉移酶和總膽紅素水平顯著下降;治療後3箇月與治療前、治療後6箇月與治療後3箇月甲狀腺激素水平和肝功能各項指標分彆進行比較,差異均有統計學意義(t=4.609～26.865,P均＜0.01).結論 對于Graves病閤併肝損害患者,131I治療優于抗甲狀腺藥物治療,噹臨床確診Graves病閤併肝損害時應首選131I治療.
목적 관찰131I치료Graves병합병간손해환자적갑상선격소수평화간공능각항지표적변화,평개131I치료적림상효과,위림상제공실천성지도.방법 회고성분석101례접수131I치료적Graves병합병간손해환자적림상자료,대치료전화치료후3、6개월갑상선격소수평화간공능각항지표적변화진행분석.결과 환자경과131I치료후6개월,갑상선공능회복정상자79례,명현호전자14례,갑상선공능감퇴자8례;간공능회복정상자94례,호전자7례.131I치료후3개월화6개월,소유환자갑상선격소수평명현강저,TSH축점회복,병안산안기전이매、천문동안산안기전이매、감성린산매、γ-곡안선전이매화총담홍소수평현저하강;치료후3개월여치료전、치료후6개월여치료후3개월갑상선격소수평화간공능각항지표분별진행비교,차이균유통계학의의(t=4.609～26.865,P균＜0.01).결론 대우Graves병합병간손해환자,131I치료우우항갑상선약물치료,당림상학진Graves병합병간손해시응수선131I치료.
Objective To observe the changing of thyroid hormone levels and hepatic function indicators of Graves disease patients with hepatic dysfunction who undergoing 131I therapy,then to evaluate the therapeutic effect and provide practical guidance for clinic.Methods The clinical data of the 101 Graves disease patients with hepatic dysfunction who had received 131I therapy were analyzed retrospectively.Thyroid hormone levels arid hepatic function indices before treatment,3 and 6 months after treatment were analyzed.Results After followed up for 6 months,of all the 101 patients,thyroid function returned to normal in 79 cases; 14 cases improved markedly; 8 cases progressed in hypothyroidism.Liver function returned to normal in 94 cases and liver function improved in 7 cases.Three and six months after 131I therapy,thyroid hormones levels of all the patients decreased significantly,and TSH restored gradually.Alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,γ-glutamyltransferanse and total bilirubin level were significantly decreased.Comparison of thyroid hormones and hepatic function indices of patients 3 months after treatment vs.the values before treatment and 6 months after treatment vs.3months after treatment,the differences were statistically significant (t=4.609～26.865,P＜0.01).Conclusion 131I therapy is better than antithyroid drugs treatment,it should be the first choice for Graves disease patients with hepatic dysfunction.
