碳酸锂联合131I治疗Graves病合并白细胞减少症的效果分析  

Clinical Study of Lithium Carbonate Combined with ^(131)I for Treatment of Graves' Disease with Leucocytopenia

作　　者：文晓琴[1] 欧阳良[1] 胡健康[2] 卢潇潇[3] 朱静茹[2] 高海波[2] 

机构地区：[1]江西省萍乡市人民医院核医学科,337000 [2]江西省萍乡市人民医院甲状腺科,337000 [3]江西省萍乡市人民医院药剂科,337000

出　　处：《天津医药》2014年第8期782-785,共4页Tianjin Medical Journal

基　　金：江西省萍乡市科技技术立项课题(20121229)

摘　　要：目的探讨碳酸锂联合131I治疗Graves病合并白细胞减少症的疗效和临床价值。方法将348例Graves病合并白细胞减少症患者随机分成试验组和对照组,试验组178例,采用碳酸锂联合131I治疗;对照组170例,仅用131I治疗。分析各组治愈率、有效率,24 h甲状腺摄131I率,游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)水平以及外周血白细胞水平。结果试验组治愈率高于对照组(87.6%vs 71.8%),2组有效率差异无统计学意义(97.8%vs 94.1%)。碳酸锂治疗1周后试验组24 h摄131I率高于对照组[(69.75±6.79)%vs(44.27±3.27)%]。治疗后2周,1个月,试验组治疗后各时点FT3及FT4水平均显著降低。而对照组在治疗后2周,FT3及FT4水平较治疗前升高,治疗后1个月后,FT3及FT4水平开始降低。试验组治疗后3个月,外周血白细胞数量即高于治疗前(4.82±0.76 vs 3.26±0.63,P<0.01)。结论碳酸锂联合131I治疗Graves病合并白细胞减少症安全、有效。Objective To explore the efficacy and clinical value of 131I combined with lithium carbonate in the treat-ment of Graves’disease with leucocytopenia. Methods Patients （n=348） were randomly divided into two groups. Experi-mental group （n=178） were treated with 131I plus lithium carbonate;Control group （n=170） were only treated with 131I. Recov-ery rate, effective rate, thyroid 131I uptake rate, the level of thyroid hormone （free triiodothyronine, FT3 and free thyroxine , FT4）and peripheral blood leukocyte were analyzed retrospectively. Results The recovery rate of the experimental group （87.6%）is significantly higher than that in the control group（71.8%）. But the effective rate of the experimental group （97.8%）is not significantly different to that in the control group（94.1%）. The 131I 24 h uptake rate in the experimental group（69.75±6.79）is higher than that in the control group（44.27±3.27）after the treatment of lithium carbonate. The level of thyroid hormone （FT3, FT4） in the experimental group are significantly lower than that before treatment after 2 weeks, 1 months. However, the levels of thyroid hormone （FT3, FT4） in the control group are higher than that before treatment after 2 weeks and began to decrease after 1 month. The treatment of experimental group contribute to the fast improvement of periph-eral blood leukocyte level. The level of peripheral blood leukocyte was significantly higher than that before treatment after 3 months（P〈0.01）. Conclusion The treatment of lithium carbonate combined with 131I for Graves’disease with leukope-nia is safe and effective.

关 键 词：格雷夫斯病 白细胞减少 碳酸锂 碘 三碘甲状腺原氨酸 甲状腺素 

分 类 号：R581.1[医药卫生—内分泌]