^(131)I治疗Graves病后甲状腺功能及骨代谢水平的变化及相关性分析  

Changes and correlation analysis of thyroid function and bone metabolism after ^(131)I treatment of Graves disease

作　　者：文晓琴[1] 高海波[2] 黎心四 李鹏 杨凭飞 张西 欧阳良[1] 张雅薇[2] WEN Xiaoqin;GAO Haibo;LI Xinsi;LI Peng;YANG Pingfei;ZHANG Xi;OUYANG Liang;ZHANG Yawei(Department of Nuclear Medicine,Pingxiang People's Hospital in Jiangxi Province,Pingxiang 337000,China;Department of Endocrinology,Pingxiang People's Hospital in Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院核医学科,江西萍乡337000 [2]江西省萍乡市人民医院内分泌科,江西萍乡337000

出　　处：《中国现代医生》2021年第23期21-24,共4页China Modern Doctor

基　　金：江西省卫生健康委员会科技计划项目(20204378)。

摘　　要：目的观察并分析^(131)I治疗Graves病后甲状腺功能及骨代谢相关指标变化,评价^(131)I治疗Graves病的疗效。方法回顾性收集2017年6月至2019年1月于我院治疗的Graves病患者120例,均予以^(131)I治疗,为治疗组;另取同期与我院体检中心检查的正常患者60例作为对照组。收集治疗组治疗前、治疗1、3、6、12个月后血清及对照组血清,采用化学发光法检测血清中骨代谢指标(TP1NP、β-CrossLaps、N-MID、PTH、Ca^(2+))和各甲状腺功能指标(FT3、FT4、TSH、TRAb)表达水平变化。结果治疗组治疗前甲状腺功能指标(FT3、FT4、TSH、TRAb)及骨代谢指标(TP1NP、β-CrossLaps、N-MID、PTH、Ca^(2+))与对照组比较,差异有统计学意义(P<0.05,P<0.01);予以^(131)I治疗1年后甲状腺及骨代谢指标趋于恢复正常(P<0.01);多因素相关性分析结果显示,甲状腺功能指标与患者BMI、酗酒及骨代谢指标明显相关。结论^(131)I的治疗方式可以有效改善Graves病患者甲状腺功能及骨代谢水平,治疗时应及时检测骨代谢水平变化,降低Graves病患者骨质疏松及骨折发病的风险。Objective To observe and analyze the changes of thyroid function and bone metabolism related indexes in patients with Graves'disease after^(131)I treatment,and to evaluate the efficacy of^(131)I in the treatment of Graves'disease.Methods A total of 120 Graves patients who were treated with^(131)I in our hospital from June 2017 to January 2019 were retrospective enrolled as the treatment group.Another 60 normal physical examination center of our hospital during the same period were selected as the control group.The serum of the treatment group before treatment,1,3,6,and 12 months after treatment and the control group were collected.Chemiluminescence method was used to detect changes in the expression levels of serum bone metabolism indexes(TP1NP,β-CrossLaps,N-MID,PTH,Ca^(2+))and various thyroid function indexes(FT3,FT4,TSH,TRAb).Results Compared with the control group,the treatment group had significant differences in thyroid function indexes(FT3,FT4,TSH,TRAb)and bone metabolism indexes(TP1NP,β-CrossLaps,N-MID,PTH,Ca^(2+))before treatment(P<0.05,P<0.01).Thyroid and bone metabolism index in the treatment group tended to be normal after^(131)I treatment for one year(P<0.01).The results of multivariate correlation analysis showed that the thyroid function index was significantly related to the patients'BMI,alcohol abuse,and bone metabolism index.Conclusion^(131)I treatment can effectively improve the thyroid function and bone metabolism in Graves patients.The changes in bone metabolism should be detected in time during treatment to reduce the risk of osteoporosis and fractures in patients with Graves disease.

关 键 词：^(131)I GRAVES病 骨代谢 甲状腺功能 

分 类 号：R581.1[医药卫生—内分泌]