CAJ | 학술논문

目的：探讨甲状腺功能亢进患者131碘（131 I）治疗前后骨密度的变化特点及131 I 治疗甲状腺功能亢进的价值。方法通过对我科甲状腺功能亢进患者按照治疗前后、性别及年龄（女性绝经后及男性＞50岁设定为高龄组，女性未绝经及男性≤50岁设为青年组）等因素进行分组，通过对131 I 治疗前[经过抗甲状腺药物（antithyroid drugs， ATD）治疗后]的骨密度及131 I 治疗后18个月的骨密度测定值进行分析；另选取同期健康体检者140例作为对照组。结果本组甲状腺功能亢进患者131 I 治疗前（ATD 治疗后）的骨密度较健康对照组减低，但同组经131 I 治疗后各部位骨密度较治疗前明显好转（P ＜0．05）。131 I 治疗前及治疗后不同性别、不同年龄组骨密度均有差异，且治疗后女性骨密度的变化值与男性组比较差异有统计学意义，青年组骨密度的变化值与高龄组差异有统计学意义（P ＜0．05）。男女高龄组骨密度的变化值差异亦有统计学意义（P ＜0．05）。结论甲状腺功能亢进时对骨密度影响较大，与性别、年龄及 ATD 的使用关系密切。ATD 治疗甲状腺功能亢进对骨密度的改善不显著，131 I 治疗后骨密度显著改善，131 I治疗甲状腺功能亢进较 ATD 对骨密度的恢复更具优势。
목적：탐토갑상선공능항진환자131전（131 I）치료전후골밀도적변화특점급131 I 치료갑상선공능항진적개치。방법통과대아과갑상선공능항진환자안조치료전후、성별급년령（녀성절경후급남성＞50세설정위고령조，녀성미절경급남성≤50세설위청년조）등인소진행분조，통과대131 I 치료전[경과항갑상선약물（antithyroid drugs， ATD）치료후]적골밀도급131 I 치료후18개월적골밀도측정치진행분석；령선취동기건강체검자140례작위대조조。결과본조갑상선공능항진환자131 I 치료전（ATD 치료후）적골밀도교건강대조조감저，단동조경131 I 치료후각부위골밀도교치료전명현호전（P ＜0．05）。131 I 치료전급치료후불동성별、불동년령조골밀도균유차이，차치료후녀성골밀도적변화치여남성조비교차이유통계학의의，청년조골밀도적변화치여고령조차이유통계학의의（P ＜0．05）。남녀고령조골밀도적변화치차이역유통계학의의（P ＜0．05）。결론갑상선공능항진시대골밀도영향교대，여성별、년령급 ATD 적사용관계밀절。ATD 치료갑상선공능항진대골밀도적개선불현저，131 I 치료후골밀도현저개선，131 I치료갑상선공능항진교 ATD 대골밀도적회복경구우세。
ABSTRACT:Objective To investigate the characteristics of bone mineral density in hyperthyroidism patients before and after 131 I treatment and its clinical value for the disease.Methods Hyperthyroidism patients were grouped by the following factors:before and after treatment,gender and age (postmenopausal women and men older than 50 years were grouped into elder group;premenopausal women and men younger than 50 years were grouped into youth group).Before 131 I treatment,patients were treated with antithyroid drug(ATD).Then,the bone mineral density was detected.At 18 months after 131 I treatment,bone mineral density was detected again.140 healthy individuals were enrolled as control group at the same time.Results The bone mineral density of hyperthyroidism patients before 131 I therapy but after ATD treatment was significantly reduced as compared with that of the healthy individuals.After 131 I treatment,bone mineral density of each part improved significantly (P <0.05).Before and after 131 I treatment,bone mineral density was remarkably different between gender or age groups.The change in females bone mineral density was markedly different from that in males after 131 I treatment (P < 0.05).The change in bone mineral density of youth group was also prominently different from that of the elder group (P <0.05).For the elder group,bone mineral density changes were also different between men and women (P <0.05).Conclusion Hyperthyroidism has a great effect on bone mineral density,which is closely corelated with gender,age and the use of ATD.ATD treatment for hyperthyroidism has little effect on bone mineral density,whereas 131 I therapy can significantly improve bone mineral density,indicating that 131 I treatment has better effect on the bone mineral density recovery of hyperthyroidism than ATD treatment.