Graves’病^(131)Ⅰ治疗发生甲减替代治疗后复发的研究  

The Observational Study on the Graves Disease Recurrence After the Replacement Therapy of Hypothyroid Induced by ^(131)Ⅰ Treatment

作　　者：刘玉婷[1] 芮东红[1] 金刚[1] 

机构地区：[1]哈尔滨医科大学附属第二医院核医学科,黑龙江哈尔滨150086

出　　处：《标记免疫分析与临床》2011年第5期311-314,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：本文对131I治疗GD后早发甲减的患者,经甲状腺激素替代治疗后再次甲亢者进行多因素随访观察,以期找到其发生的相关因素。将18例131I治疗GD后发生甲减给予甲状腺素治疗后甲亢复发者,与30例131I治疗GD甲减后给予甲状腺素治疗甲亢未复发者进行对比,并经1、3、6、9、12月随访,回顾性分析治疗前后TGAb、TPOAb值、临床体征、精神状态、周围生活环境、体力劳动强度、情绪变化、生活习惯、身体健康状态等多种因素,影响因素分析采用t检验与χ2检验分析。结果显示:甲亢复发与未复发两组TGAb、TPOAb水平不具有统计学意义(P>0.05);两组131I给药量与年龄比较也不具有统计学意义(P>0.05);甲状腺激素替代治疗时间早晚与情绪变化大两组比较具有统计学意义(P<0.05)。结论:131I治疗后出现甲减,经甲状腺激素替代治疗一段时间后再次出现甲亢复发的患者可能与甲状腺激素替代治疗时间过早及患者的情绪变化过大有关。This article used multi-factor revisiting observation method on the patients who had hypothyroid induced by 131I treatment and then recurred hyperthyroid to find some relative factors,18 cases of re-hyperthyroidism was compared with 30 cases without hyperthyroid recurrence.All of the patients were given thyroxine when they got hypothyroid after ^131I treatment.Through 1,3,6,9 and 12 months following-up study,the levels of TGAb and TPOAb,clinical signs,mental state,living environment,strength of their labor,mood changes,daily habits,health were analyzed retrospectively.The t-test and χ^2 test were used to analyze the influencing factors.The results showed that the TGAb and TPOAb levels in hyperthyroid recurrence group had no statistic significance with patients without hyperthyroid recurrence group（P〉0.05）;131I dose and the age in two groups had not statistic significance（P〉0.05）.The thyroxine substitution treatment time and mood change in two groups had statistic significance（P〉0.05）.Through thyroxine substitution treatment,hyperthyroid may recur in the patients who have hypothyroid induced by 131I treatment,which may be related with early thyroxine substitution treatment and big mood change.

关 键 词：131I治疗 Graves'病 甲减 

分 类 号：R581.1[医药卫生—内分泌]