Graves甲亢患者131Ⅰ治疗前后凝血功能指标及血小板参数的变化  

Changes of Coagulation Function and Platelet Parameters in Patients withGraves′Hyperthyroidism Before and After 131Ⅰ Treatment

作　　者：李杰[1] 尹义梅[2] 刘世浩 李东辉[1] LI Jie;YIN Yimei;LIU Shihao;LI Donghui(Sixth Department of Surgery,First Hospital of Handan City,Handan 056002,China;Second Department of Cardiology,First Hospital of Handan City,Handan 056002,China)

机构地区：[1]邯郸市第一医院普外六科,河北邯郸056002 [2]邯郸市第一医院心内二科,河北邯郸056002

出　　处：《标记免疫分析与临床》2020年第12期2134-2137,2175,共5页Labeled Immunoassays and Clinical Medicine

基　　金：河北省重点研发计划(编号:172777150);邯郸市科技局项目(编号:1823208078ZC)。

摘　　要：目的探讨放射性碘-131(iodine-131,131Ⅰ)治疗甲亢Graves病(Graves′disease,GD)前后凝血功能指标及血小板参数的变化及其意义。方法选取我院2015年1月至2019年1月收治的初诊为Graves病且甲状腺功能亢进的患者35例,定义为甲亢组,该组所有患者均接受131Ⅰ治疗,另选取同期35例体检健康者为对照组。测定甲亢组治疗前、后及对照组甲状腺功能、凝血功能、血小板参数的变化。结果治疗前,甲亢组较对照组相比促甲状腺激素(thyroid-stimulating hormone,TSH)明显降低,游离三碘甲状腺原氨酸(free thyroxine 3,FT3)及游离甲状腺素(free thyroxine 4,FT4)明显升高,P<0.05。治疗后,甲亢组FT3、FT4明显降低,与治疗前比差异有统计学意义,P<0.05,与对照组相比差异无统计学意义,治疗后TSH明显升高,与治疗前及对照组相比差异仍有统计学意义,P<0.05。与对照组相比,甲亢组治疗前大血小板比率(platelet-large cell ratio,P-LCR)、血小板计数(platelet count,PLT)、平均血小板容积(mean platelet volume,MPV)、血小板体积分布宽度(platelet distribution width,PDW)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)、凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)、血浆D-二聚体(D-dimer,D-D)差异均存在统计学意义,P均<0.05。治疗后甲亢组与对照组相比DW、APTT、PT、P-LCR差异无统计学意义,P均>0.05。甲亢组治疗前后APTT、TT、PT、FIB,D-D差异存在统计学意义,P均<0.05,甲亢组治疗前后P-LCR、PLT、MPV、PDW相比则差异无统计学意义。相关分析显示PT、FIB与FT3、FT4呈正相关,PLT与FT3呈负相关,P均<0.05。结论与正常健康者相比,甲亢患者普遍处于高凝状态,存在凝血功能紊乱现象,经131Ⅰ治疗后凝血指标及血小板参数随着甲状腺激素水平发生改变,临床上监测凝血功能及血小板参数对潜在血栓风险的评估具有一定的�Objective To explore the changes of coagulation function and platelet parameters before and after treatment of Graves disease(GD) with radioactive iodine-131.Methods 35 patients with Graves′ disease and hyperthyroidism admitted to our hospital from January, 2015 to January, 2019 were selected and defined as the hyperthyroidism group, in which all patients received 131Ⅰ treatment, while 35 healthy patients admitted during the same period were selected as the control group. The changes of thyroid function, coagulation function and platelet parameters in the hyperthyroidism group before and after treatment and the control group were then measured.Results Before treatment, compared with the control group, thyroid stimulating hormone(TSH) was significantly decreased in the hyperthyroidism group, while FT3 and FT4 were significantly increased(P<0.05). After treatment, FT3 and FT4 in the hyperthyroidism group were significantly reduced, compared with the ratio before treatment(P<0.05), but there was no statistical difference when compared with the control group. TSH was significantly increased after treatment, with a significant difference when compared with the control group and before treatment(P<0.05). Compared with control group, the hyperthyroidism group showed significant differences in the large platelet ratio(P-LCR), platelet count(PLT), mean platelet volume(MPV) and platelet volume distribution width(PDW), activated partial blood coagulation live enzymes time(APTT), thrombin time, thrombin time, TT), prothrombin time(PT) and fibrinogen(FIB), and plasma D-dimer(D-D) before treatment(P<0.05). After treatment, DW, APTT, PT and p-lcr in the hyperthyroidism group were not significantly different from those in the control group(all P>0.05). There were significant differences in APTT, TT, PT, FIB and D-D in the hyperthyroidism group between before and after treatment(all P<0.05), while there were no statistically significant differences in P-LCR, PLT, MPV and PDW in the hyperthyroidism group between before and aft

关 键 词：甲状腺功能亢进症 GRAVES病 放射性碘-131 血小板参数 凝血功能 

分 类 号：R581.1[医药卫生—内分泌]