碘131联合甲巯咪唑对甲状腺功能亢进患者骨代谢的影响  

Effect of iodine 131 combined with Methimazole on bone metabolism in patients with hyperthyroidism

作　　者：陈茹芬[1] 叶伟坚[1] 罗剑彬[1] 刘苑红[1] 黎秀娟[1] Ru-fen Chen;Wei-jian Ye;Jian-bin Luo;Yuan-hong Liu;Xiu-juan Li(Department of Nuclear Medicine, Huizhou Central People's Hospital,Huizhou, Guangdong 516001, China)

机构地区：[1]广东省惠州市中心人民医院核医学科,广东惠州516001

出　　处：《中国现代医学杂志》2017年第18期83-86,共4页China Journal of Modern Medicine

摘　　要：目的探讨碘131联合甲巯咪唑用于治疗甲亢患者的疗效,分析其对患者骨代谢指标及CXC趋化因子配体10(CXCL10)、CC趋化因子配体22(CCL22)水平的影响。方法选取2013年11月-2015年11月惠州市中心人民医院收治的184例甲亢患者为研究对象,随机分为实验组和对照组,实验组患者给予碘131联合甲巯咪唑进行治疗,对照组患者仅给予甲巯咪唑进行治疗。治疗2个月,对比两组患者的甲状腺功能,骨代谢指标及血清CXCL10、CCL22水平。结果经治疗后两组患者的总三碘甲状腺原氨酸(TT3)、总四碘甲状腺原氨酸(TT_4)、游离三碘甲状腺原氨酸(FT_3)及游离四碘甲状腺原氨酸(TT_4)水平均降低,且实验组低于对照组(P<0.05);实验组的治疗总有效率为93.47%,高于对照组(76.1%)(P<0.05);经治疗后两组患者的血清降钙素(CT)、骨钙素(BGP)水平降低,实验组低于对照组(P<0.05);治疗后,两组患者的PTH水平均升高,实验组高于对照组(P<0.05);治疗后两组患者的血清CXCL10、CCL22水平降低,且实验组低于对照组患者(P<0.05)。结论小剂量碘131联合甲巯咪唑治疗甲状腺功能亢进患者能够有效改善患者的甲状腺功能及骨代谢情况,调节Th1/Th2细胞的失衡,降低CXCL10、CCL22表达水平,改善患者的临床状况。Objectives To analyze the influence of iodine131combined with Methimazole on bone metabolism and serum CXCL10,CCL22in patients with hyperthyroidism.Methods A total of184patients with hyperthyroidism from November2013to November2015were randomly divided into experimental group(92cases)and control group(92cases).The patients in the experimental group were treated with iodine131combined with Methimazole and the patients in the control group were treated with only Methimazole.The thyroid function,the bone metabolism index and the levels of serum CXCL10and CCL22were evaluated and compared after treatment for2months.Results The levels of TT3,TT4,FT3and FT4all declined in the two groups,and declined more obviously in the experimental group than in the control group(P<0.05).The total effective rate in the experimental group was93.47%,which was significantly higher than that in the control group(P<0.05).The levels of CT and BGP declined in the two groups,but more obvious in the experimental group(P<0.05).The level of PTH increased in the two groups,but more significant in the experimental group(P<0.05).The levels of CXCL10and CCL22decreased in the two groups,but more significant in the experimental group than in the control group(P<0.05).Conclusions A small dose of iodine131combined with Methimazole can significantly improve the thyroid function and bone metabolism,correct the imbalance of Th1/Th2,lower the levels of CXCL10and CCL22and improve the patients'condition.

关 键 词：碘131 甲巯咪唑 甲状腺功能亢进 骨代谢 

分 类 号：R581.1[医药卫生—内分泌]