摘要
目的分析Graves病患者行131I治疗后短期内并发甲状腺相关性眼病的相关因素。方法收集19例Graves病行131I治疗后3个月内并发甲状腺相关性眼病患者资料，以同期人院进行131治疗的Graves病64例为对照组，比较治疗前后促甲状腺素受体抗体（TRAb）、甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）、肿瘤坏死因子-0【（TNF-a），治疗前后甲状腺功能变化等因素。结果新发眼病组TPOAb、TRAb、TNF-a基线水平与未发眼病组差异无统计学意义，而治疗后明显上升（TPOAb：t=-5．632，P=0．000；TRAb：t=-3．284，P=0．002；TNF-0l：t=-3．907，P=0．000）；新发眼病组治疗后1个月Fr，升高，而未发眼病组未升高（t=9．475，P=0．000）；治疗后3个月甲功下降幅度两组差异无统计学意义，眼病与该期间是否发生甲减不相关；131I治疗前甲状腺功能的水平、甲状腺重量（t=0．211，P=0．833）、吸碘率（t=1．235。P=0．221）、性别（x=1．554，P=0．213）、年龄（t=0．154，P=0．878）、病程（Z=0．761，P=0．447）与甲状腺相关性眼病的发生不相关。结论Graves病患者131I治疗后TRAb、TPOAb、TNF．Q升高及短期FT，升高与新发甲状腺相关性眼病相关，需正确衡量其治疗后发病风险，早期预防和干预。
Objective To analyze the relevant factor of newly diagnosed thyroid associated ophthalmopathy （TAO） after radioiodine treatment of Graves disease（GD） in short term. Methods A total of 19 patients with GD and TAO in three months after radioiodine treatment were selected as observation group,64 patients with GD treated by radioiodine in the same period were selected as control group. The thyrotrophic receptor antibody （ TRAb ）, thyroglobulin antibody （TGAb）, thyroid peroxidase antibody （TPOAb）, tumor necrosis faetor alpha （TNF- ct） and the changes of thyroid function before and after treatment were compared. Results The base line levels of TPOAb, TRAb and TNF - ct had no statistically significant differences between the observation group and the control group, but the aseensional range became bigger after treatment （ TPOAb ： t = - 5. 632, P = 0.000 ; TRAb ： t = - 3. 284, P = 0.002 ; TNF - ct ： t = - 3. 907, P = 0.000）. One month later, FT3 level increased in the observation group after treatment, but that had no significant change in the control group （ t = 9. 475, P = 0.000 ）. After 3 months, the falling range of thyroid function had no statistically significant difference between the two groups, which suggested that the TAO was not related to hypothyroidism. The thyroid function, thyroid weight （t = 0.211, P = 0. 833 ）, rate of iodine intake （t = 1. 235, P = 0. 221 ） ,gender （ X2 = 1. 554 ,P =0.213） ,age （t =0. 154,P =0.878） ,course of disease before radioiodine treatment （Z=0.761 ,P=0.447） were irrelevant to the occurrence of TAO. Conclusion The rise of TRAb,TPOAb,TNF-ct and thyroid function are related to TAO after radioiodine treatment. Identifying the risk factors to predispose patients with GD to develop TAO can dramatically alter the management of these patients.
出处
《中国基层医药》
CAS
2017年第24期3709-3714,I0035,共7页
Chinese Journal of Primary Medicine and Pharmacy
