^(131)I治疗甲状腺功能亢进症合并甲状腺功能亢进性肝病疗效观察  

Therapeutic effect of ^(131)I on hyperthyroidism complicated with hyperthyroid hepatopathy

作　　者：李镜发[1] 邹德环[1] 朱旭生[1] 佘立群[1] 

机构地区：[1]广州市第一人民医院核医学科,510180

出　　处：《中华实用诊断与治疗杂志》2015年第3期295-296,299,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨131I治疗甲状腺功能亢进症(甲亢)合并甲状腺功能亢进性肝病(甲亢性肝病)的效果。方法 58例甲亢合并甲亢性肝病患者均给予131I治疗,分别于治疗前及治疗3个月后检测促甲状腺激素(thyroid stimulating hormone,TSH)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、总三碘甲状腺原氨酸(total triiodothyronine,TT3)、总甲状腺素(total thyroxine,TT4)、谷丙转氨酶(glutamic-pyruvic transaminase,GPT),谷草转氨酶(glutamic-oxaloacetic transaminase,GOT)、碱性磷酸酶(alkaline phosphatase,ALP)、γ-谷氨酰转肽酶(γ-glutamyl transpeptadase,γ-GT)、总胆红素(total bilirubin,TBil)、直接胆红素(direct bilirubin,DBil)水平,并评定治疗后3个月疗效。结果 131I治疗3个月后患者血清TSH((1.84±0.64)mu/L)高于治疗前((0.01±0.00)mu/L)(P<0.01),FT3((5.12±1.75)pmol/L)、FT4((18.34±4.98)pmol/L)、TT3((2.75±1.98)nmol/L)、TT4((65.48±56.28)nmol/L)、GPT((35.10±29.15)u/L)、GOT((30.12±17.58)u/L)、ALP((83.21±45.46)u/L)、γ-GT((46.35±33.78)u/L)、TBil(13.25±4.97)μmol/L)、DBil((3.75±1.46)μmol/L)水平均较治疗前降低(FT3为(15.28±2.45)pmol/L、FT4为(57.58±8.91)pmol/L、TT3为(6.38±2.37)nmol/L、TT4为(245.17±62.14)nmol/L、GPT为(90.25±44.12)u/L、GOT为(55.38±30.27)u/L、ALP为(103.11±53.14)u/L、、γ-GT为(82.54±57.12)u/L、TBil为(15.98±8.49)μmol/L、DBil为(5.87±4.26)μmol/L)(P<0.01);治疗3个月后评定治疗效果,甲亢治愈率为43.10%(25/58)。结论 131I治疗甲亢合并甲亢性肝病效果满意,且可改善患者肝功能。Objective To explore the effect of ^131 I on hyperthyroidism complicated with hyperthyroid hepatopathy.Methods Fifty-eight patients with hyperthyroidism complicated with hyperthyroid hepatopathy were treated by ^131 I.The levels of thyroid stimulating hormone（TSH）,free triiodothyronine（FT3）,free thyroxine（FT4）,total triiodothyronine（TT3）,total thyroxine（TT4）,glutamic-pyruvic transaminase（GPT）,glutamic-oxaloacetic transaminase（GOT）,alkaline phosphatase（ALP）,γ-glutamyl transpeptadase（γ-GT）,total bilirubin（TBil）,and direct bilirubin（DBil）were detected before and after 3-month treatment,and the therapeutic effect was evaluated after 3-month treatment.Results The level of TSH was higher after 3-month treatment（（1.84±0.64）mu/L）than that before treatment（（0.01±0.00）mu/L）（P〈0.01）.And the levels of FT3（（5.12±1.75）pmol/L）,FT4（（18.34±4.98）pmol/L）,TT3（（2.75±1.98）nmol/L）,TT4（（65.48±56.28）nmol/L）,GPT（（35.10±29.15）u/L）,GOT（（30.12±17.58）u/L）,ALP（（83.21±45.46）u/L）,γ-GT（（46.35±33.78）u/L）,TBil（13.25±4.97）μmol/L）and DBil（（3.75±1.46）μmol/L）after 3-month treatment were lower than those before treatment（FT3：（15.28±2.45）pmol/L,FT4：（57.58±8.91）pmol/L,TT3：（6.38±2.37）nmol/L,TT4：（245.17±62.14）nmol/L,GPT：（90.25±44.12）u/L,GOT：（55.38±30.27）u/L,ALP：（103.11±53.14）u/L,γ-GT：（82.54±57.12）u/L,TBil：（15.98±8.49）μmol/L,DBil：（5.87±4.26）μmol/L）（P〈0.01）.The recovery rate of hyperthyroidism after 3-month treatment was 43.10%（25/58）.Conclusion ^131 I can achieve a satisfactory result for hyperthyroidism complicated with hyperthyroid hepatopathy,and can improve the liver function.

关 键 词：甲状腺功能亢进症 甲状腺功能亢进性肝病 ^131I 

分 类 号：R581.1[医药卫生—内分泌]