放射性^131I对甲亢TRAb、TSH及预后的影响  

Effect of radioiodine-131 on TRAb, TSH and prognosis in hyperthyroidism

作　　者：陈茹芬[1] 叶伟坚[1] 罗剑彬[1] 刘苑红[1] 

机构地区：[1]广东省惠州市中心人民医院核医学科,516001

出　　处：《中国实用医刊》2017年第5期53-55,共3页Chinese Journal of Practical Medicine

摘　　要：目的 探讨放射性131I对Graves病甲状腺功能亢进患者血清促甲状腺激素受体抗体（TRAb）、促甲状腺激素（TSH）的影响及甲状腺功能减退的发生率。方法 选取2013年7月至2015年12月120例甲状腺功能亢进患者的临床资料行回顾性分析，检测并分析治疗前后患者血清甲状腺激素、TRAb的水平变化，探讨甲减患者TSH水平的影响因素。结果治疗后，患者三碘甲状腺氨酸（TT3）、血清总甲状腺素（TT4）、TRAb、游离三碘甲状腺原氨酸（FT3）、游离总甲状腺素（FT4）较治疗前均显著降低（P〈0.05），TSH、甲状腺球蛋白抗体（TGAb）、甲状腺过氧物酶抗体（TPOAb）较治疗前均显著升高（P〈0.05）；治疗后6个月内出现甲状腺功能减退44例（36.67%），以治疗后TSH水平为因变量，以治疗前TT3、TT4、TRAb、FT3、FT4、TGAb、TPOAb为自变量，结果发现甲状腺功能减退患者治疗后TSH水平与TT3、TT4、TRAb、FT3、FT4呈负相关（P〈0.05），与TGAb、TPOAb呈正相关（P〈0.05）。结论放射性131I治疗Graves病甲状腺功能亢进效果显著，但要警惕甲状腺功能减退的发生。Objective To investigate the effect of radioiodine-131 on serum thyrotropin receptor antibody （TRAb）, thyroid stimulating hormone （TSH） and the incidence of hypothyroidism of Graves hyperthyroidism. Methods From July 2013 to December 2015, 120 cases of hyperthyroidism in nuclear medicine were retrospectively analyzed, the serum thyroid hormone and TRAb levels before and after treatment, and the influencing factors of TSH in patients with hypothyroidism were analyzed. Results After treatment, the levels of TT3, TF4, TRAb, FT3, FT4 significantly decreased than those before treatment （P 〈 0.05 ） , the levels of TSH, TGAb, TPOAb significantly increased than those before treatment （P 〈 0. 05 ）. After 6 months of treatment, hypothyroidism occurred in 44 patients （36.67%）, the TSH level after treatment was selected as the dependent variable, the levels of TT3, Tl＇4, TRAb, YT3, FT4, TGAb, TPOAb as independent variables, the results showed that, TSH was negatively correlated with TT3, TT4, TRAb, FT3, FT4 after treatment in patients with hypothyroidism （P 〈 0. 05 ） , and TSH was positively correlated with TGAb, TPOAb （ P 〈 0.05 ）. Conclusions The effect of Radioiodine- 131 on Graves disease hyperthyroidism patients is remarkable, but to alert hypothyroidism.

关 键 词：放射性碘-131 GRAVES病 甲状腺功能亢进 促甲状腺激素受体抗体 促甲状腺激素 

分 类 号：R581.1[医药卫生—内分泌]