摘要
目的观察Graves病(GD)患者碘-131(^(131)I)治疗3个月后,早发甲状腺功能减退症(甲减)患者使用左甲状腺素钠(加衡)替代治疗使促甲状腺激素(TSH)维持在不同水平永久性甲减的发生率。方法选取2016年3月至11月河北北方学院附属第一医院行^(131)I治疗后3个月诊断为甲减的GD患者70例,随机分为A组(35例)给予加衡替代治疗,使TSH维持在正常水平(0.27~4.2 mIU/L);B组(35例)给予加衡替代治疗,使TSH维持在正常稍高水平(4.2~10 mIU/L)。测定甲状腺功能,观察^(131)I治疗1年后永久性发甲减发生率。结果^(131)I治疗1年后,TSH维持在正常水平的患者永久性甲减发生率为88.6%,TSH维持在正常稍高水平的患者永久性甲减发生率为65.7%,差异有统计学意义(χ~2=5.185,P<0.05)。结论 GD患者^(131)I治疗3个月后发现早发甲减给予左甲状腺素钠替代治疗使TSH维持在正常值上线稍高水平能降低^(131)I治疗后永久性甲减的发生率。
Objective To observe the incidence of permanent hypothyroidism at different thyroid stimulating hormone （TSH） levels maintained by levothyroxine sodium （Jiaheng） replacement therapy in early-onset hypothyroidism patients with Graves＇ disease （ GD ） treated with iodine-131 （131 I ） for 3 months. Methods Seventy patients diagnosed as hypothyroidism by rechecking thyroid function 3 months after 131 I treatment because of GD were randomly divided into group A in which alternative therapy was given with TSH at normal level about 0.27 - 4.2 mIU/L and group B in which alternative therapy was given with TSH at normal and slightly higher levels about 4.2 - 10 mIU/L （ n = 35, each ）. The incidence of permanent hypothyroidism was observed by determination of thyroid function after treatment with 131 I for one year. Results After treatment with 131 I for one year, the incidence of permanent hypothyroidism was 88.6% in group A and 65.7% in group B （X2 = 5. 185, P 〈 0.05 ）. Conclusion In early-onset hypothyroidism patients with GD treated with 131 I for 3 months, the incidence of permanent hypothyroidism can be reduced significantly by using levothyroxine sodium replacement therapy to keep TSH at a slightly higher level.
作者
曹丙花
冯君帆
程丹
张惠敏
任卫东
CAO Bing-hua;FENG Jun-fan;CHENG Dan;ZHANG Hui-min;REN Wei-dong(Graduate Department of Hebei North University, Zhangjiakou, Hebei 075000, Chin)
出处
《中国临床研究》
CAS
2018年第6期793-795,共3页
Chinese Journal of Clinical Research
