放射性碘治疗对Graves病患者甲状腺功能及T淋巴细胞的影响  

Effect of radioiodine therapy on thyroid function and T lymphocytes in patients with Graves’disease

作　　者：魏晓华[1] 李旭 杜晓洋 Wei Xiao-Hua;Li Xu;Du Xiao-Yang(Department of Endocrinology,Anyang Regional Hospital of Puyang City,Anyang 455000,China)

机构地区：[1]濮阳市安阳地区医院内分泌科,安阳455000

出　　处：《中国药物应用与监测》2024年第6期708-712,共5页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探究放射性碘治疗对Graves病患者甲状腺功能及T淋巴细胞功能的影响。方法选取濮阳市安阳地区医院2023年1月至2024年6月确诊的137例Graves病患者为研究对象,根据治疗方式的不同将其分为观察组76例(采用131Ⅰ治疗)和对照组61例(采用甲巯咪唑药物治疗)。比较两组的临床疗效、甲状腺功能、T淋巴细胞变化,并分析甲状腺功能与T淋巴细胞变化之间的相关性。结果观察组治疗总有效率为89.47%(68/76),高于对照组的73.77%(45/61)(χ^(2)=5.775,P=0.016)。两组患者治疗1个月、3个月后FT_(3)和FT_(4)较治疗前下降,TSH较治疗前增加(均P<0.05);治疗1个月后,观察组FT_(4)低于对照组(t=5.455,P<0.001);治疗3个月后,观察组FT_(3)和FT_(4)低于对照组(t=7.794、2.775,均P<0.05),TSH高于对照组(t=2.965,P=0.004)。两组患者治疗1、3个月后CD3+T淋巴细胞比例较治疗前增加,CD4^(+)T淋巴细胞比例治疗1个月后减少,治疗3个月后增加(均P<0.05);观察组治疗3个月后CD3^(+)T淋巴细胞比例相较于对照组更高,CD4^(+)T淋巴细胞比例低于对照组(t=3.780、2.775,均P<0.05)。CD4^(+)T淋巴细胞比例与FT_(3)、FT_(4)和TSH水平呈正相关(r=0.453、0.495、0.594,均P<0.05),CD4^(+)/CD8^(+)比值与FT_(3)、FT_(4)和TSH水平呈正相关(r=0.512、0.592、0.474,均P<0.05)。结论Graves病131Ⅰ治疗效果优于甲巯咪唑,且能改善甲状腺功能,提升患者的免疫功能。Graves病患者的131Ⅰ治疗应关注甲状腺功能和免疫功能相关指标。Objective To explore the effects of radioactive iodine treatment on thyroid function and T lymphocyte function in patients with Graves’disease.Methods A total of 137 patients diagnosed with Graves’disease and treated in Anyang Regional Hospital of Puyang City from January 2023 to June 2024 were selected for the study.According to different treatment methods,these patients were divided into the observation group(n=76,treated with 131Ⅰ)and the control group(n=61,treated with methimazole).Clinical efficacy,thyroid function,and changes in T lymphocyte function were compared between the two groups and the correlation of thyroid function to T lymphocyte changes was analyzed.Results The effective rate in the observation group was 89.47%(68/76),which was significantly higher than that of 73.77%(45/61)in the control(χ^(2)=5.775,P=0.016).One month and three months after treatment,the FT_(3)and FT_(4)levels in both groups were remarkably decreased while TSH levels increased(P<0.05).One month after treatment,the FT4 level in the observation group was lower than that in the control(t=5.455,P<0.001).Three months after treatment,the FT3 and FT_(4)levels in the observation group were lower than those in the control(t=7.794,2.775,both P<0.05),and the TSH level was higher than that in the control(t=2.965,P=0.004).One month and three months after treatment,the proportion of CD3^(+)T cells in both groups was obviously increased,while the proportion of CD4^(+)T cells decreased one month after treatment and increased three months after treatment(P<0.05).Three months after treatment,the proportion of CD3^(+)T cells in the observation group was higher than that in the control,and the proportion of CD4^(+)T cells was lower in the observation group(t=3.780,2.775,both P<0.05).The proportion of CD4^(+)T cells was positively correlated with FT_(3),FT_(4),and TSH levels(r=0.453,0.495,0.594,all P<0.05),and the CD4^(+)/CD8^(+)ratio was also positively correlated with FT_(3),FT_(4),and TSH levels(r=0.512,0.592,0.474,all P<0.05).Conclusion

关 键 词：放射性碘治疗 GRAVES病 甲状腺功能 免疫功能 淋巴细胞 

分 类 号：R581.1[医药卫生—内分泌]