华中科技大学学报(医学版)
華中科技大學學報(醫學版)
화중과기대학학보(의학판)
ACTA UNIVERSITATIS MEDICINAE TONGJI
2015年
1期
110-113
,共4页
徐金娥%彭秋菊%邓波%李裕明
徐金娥%彭鞦菊%鄧波%李裕明
서금아%팽추국%산파%리유명
Graves病%甲状腺功能减退症%131 I治疗%促甲状腺激素受体抗体%抗甲状腺过氧化物酶抗体%白细胞介素-17
Graves病%甲狀腺功能減退癥%131 I治療%促甲狀腺激素受體抗體%抗甲狀腺過氧化物酶抗體%白細胞介素-17
Graves병%갑상선공능감퇴증%131 I치료%촉갑상선격소수체항체%항갑상선과양화물매항체%백세포개소-17
Graves’ disease%hypothyroidism%radioiodine treatment%TRAb%A-TPO%IL-17
目的:回顾分析222例行131 I治疗的Graves病患者,评估各临床指标对预后的影响及131 I治疗对抗甲状腺过氧化物酶抗体(A‐TPO)、促甲状腺激素受体抗体(TRAb)、白细胞介素‐17(IL‐17)的影响。方法比较222例患者131 I治疗后半年的临床效果,根据治疗后甲状腺功能评估,将患者分为治疗后甲亢组、正常组、甲减组;Logistic回归分析患者性别、病程、发病年龄、甲状腺重量、摄碘率、治疗前 TRAb水平与疗效之间的关系;分析131 I治疗对 A‐TPO、TRAb、IL‐17水平的影响。结果治疗前甲状腺重量、TRAb水平为影响疗效的独立危险因素(OR值分别为1.108、8.917,P值分别为0.0094、0.0411);A‐TPO值在治疗后转归为甲减组较治疗前明显升高(P<0.05),而甲亢组和正常组患者较治疗前均无明显变化(P>0.05);TRAb值在治疗后转归为甲亢组和甲减组患者较治疗前明显升高(P<0.05),而正常组较治疗前无明显变化( P>0.05);IL‐17值在131 I治疗前后各组均无明显变化( P>0.05)。结论甲状腺重量越大、治疗前TRAb的水平越高,131 I治疗失败的可能性越大;治疗后半年A‐TPO升高明显者更容易发生甲减;治疗后 TRAb、IL‐17水平与预后的关系不明确。
目的:迴顧分析222例行131 I治療的Graves病患者,評估各臨床指標對預後的影響及131 I治療對抗甲狀腺過氧化物酶抗體(A‐TPO)、促甲狀腺激素受體抗體(TRAb)、白細胞介素‐17(IL‐17)的影響。方法比較222例患者131 I治療後半年的臨床效果,根據治療後甲狀腺功能評估,將患者分為治療後甲亢組、正常組、甲減組;Logistic迴歸分析患者性彆、病程、髮病年齡、甲狀腺重量、攝碘率、治療前 TRAb水平與療效之間的關繫;分析131 I治療對 A‐TPO、TRAb、IL‐17水平的影響。結果治療前甲狀腺重量、TRAb水平為影響療效的獨立危險因素(OR值分彆為1.108、8.917,P值分彆為0.0094、0.0411);A‐TPO值在治療後轉歸為甲減組較治療前明顯升高(P<0.05),而甲亢組和正常組患者較治療前均無明顯變化(P>0.05);TRAb值在治療後轉歸為甲亢組和甲減組患者較治療前明顯升高(P<0.05),而正常組較治療前無明顯變化( P>0.05);IL‐17值在131 I治療前後各組均無明顯變化( P>0.05)。結論甲狀腺重量越大、治療前TRAb的水平越高,131 I治療失敗的可能性越大;治療後半年A‐TPO升高明顯者更容易髮生甲減;治療後 TRAb、IL‐17水平與預後的關繫不明確。
목적:회고분석222례행131 I치료적Graves병환자,평고각림상지표대예후적영향급131 I치료대항갑상선과양화물매항체(A‐TPO)、촉갑상선격소수체항체(TRAb)、백세포개소‐17(IL‐17)적영향。방법비교222례환자131 I치료후반년적림상효과,근거치료후갑상선공능평고,장환자분위치료후갑항조、정상조、갑감조;Logistic회귀분석환자성별、병정、발병년령、갑상선중량、섭전솔、치료전 TRAb수평여료효지간적관계;분석131 I치료대 A‐TPO、TRAb、IL‐17수평적영향。결과치료전갑상선중량、TRAb수평위영향료효적독립위험인소(OR치분별위1.108、8.917,P치분별위0.0094、0.0411);A‐TPO치재치료후전귀위갑감조교치료전명현승고(P<0.05),이갑항조화정상조환자교치료전균무명현변화(P>0.05);TRAb치재치료후전귀위갑항조화갑감조환자교치료전명현승고(P<0.05),이정상조교치료전무명현변화( P>0.05);IL‐17치재131 I치료전후각조균무명현변화( P>0.05)。결론갑상선중량월대、치료전TRAb적수평월고,131 I치료실패적가능성월대;치료후반년A‐TPO승고명현자경용역발생갑감;치료후 TRAb、IL‐17수평여예후적관계불명학。
Objective To explore the effects of each clinical factor on the prognosis of Graves’disease after radioiodine treatment and the effects of radioiodine on the levels of anti‐thyroid peroxidase antibody(A‐TPO) ,thyrotropin receptor antibody (TRAb)and interleukin‐17(IL‐17).Methods Clinical data of 222 patients who were treated with radioactive iodine for six months were retrospectively analyzed. They were divided into hyperthyroid ,hypothyroid and euthyroid groups according to their thyroid function. Logistic regression analysis was used to analyze the association of gender ,duration of disease ,age of onset ,the weight of the thyroid ,radioactive iodine uptake ,serum TRAb levels before treatment with the treatment efficacy. The impact of radioiodine treatment on the levels of A‐TPO ,TRAb and IL‐17 was examined as well.Results The weight of the thyroid and serum TRAb levels before radioiodine treatment were independent risk factors for the efficacy of radioiodine treatment (OR:1.108 and 8.917 ,P=0.009 4 and 0.041 1 ,respectively).After 6‐month treatment ,the titers of A‐TPO were increased signifi‐cantly in the hypothyroid group(P< 0.05) ,but not in the hyperthyroid and the euthyroid groups(P> 0.05).The titers of TRAb were increased significantly in the hyperthyroid group and the hypothyroid group (P<0.05) ,but not significantly in the euthyroid group(P>0.05). The titers of IL‐17 had no significant changes after the treatment in all three groups.Conclusion The higher TRAb levels and the greater thyroid weigh before radioiodine treatment are associated with a relative resistance to the therapy.Patients with high levels of A‐TPO after radioiodine treatment for six months tend to develop hypothyroidism.The association of the levels of TRAb and IL‐17 with prognosis is undetermined.