甲状腺功能亢进患者^(131)碘治疗前后骨密度的变化  

Bone mineral density change in hyperthyroidism patients before and after ^(131)I treatment

作　　者：王勇[1] 丁勇[1] 邢家骝[1] 张友仁[1] 管美超 

机构地区：[1]解放军第307医院核医学科,北京100071

出　　处：《临床荟萃》2015年第1期74-77,共4页Clinical Focus

摘　　要：目的探讨甲状腺功能亢进患者131碘(131I)治疗前后骨密度的变化特点及131I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131I治疗前[经过抗甲状腺药物(antithyroid drugs,ATD)治疗后]的骨密度及131I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131I治疗前(ATD治疗后)的骨密度较健康对照组减低,但同组经131I治疗后各部位骨密度较治疗前明显好转(P<0.05)。131I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,131I治疗后骨密度显著改善,131I治疗甲状腺功能亢进较ATD对骨密度的恢复更具优势。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.

关 键 词：甲状腺危象 碘同位素 骨密度 抗甲状腺药 

分 类 号：R581.1[医药卫生—内分泌]