摘要
目的研究甲状腺自身抗体对放射性碘(131I)治疗甲状腺功能亢进症(以下简称甲亢)临床转归的影响。方法选取2016年7月—2017年4月华北理工大学附属医院收治的194例经131I治疗的甲亢患者作为研究对象。根据治疗前甲状腺自身抗体结果分为A组[促甲状腺素受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPOAb)均阴性)]、B组(TRAb阳性、TPOAb阴性)、C组(TRAb阴性、TPOAb阳性)及D组(TRAb、TPOAb均阳性)。随访1年后比较甲亢患者治疗前不同甲状腺自身抗体与131I治疗后临床转归的关系。结果①经131I治疗1年的甲亢患者有效率为80.4%,其中甲状腺功能正常为52.0%,甲状腺功能减退症(以下简称甲减)(包括亚临床甲减)为28.4%;无效率即甲亢(包括亚临床甲亢)为19.6%。②甲亢患者不同甲状腺自身抗体经131I治疗后的临床转归的构成比不同(P<0.05)。③B、D组甲亢结果与A、C组比较,差异有统计学意义(P<0.05),而B组甲亢结果与D、A及C组比较,差异无统计学意义(P>0.05);B、C组甲减结果与A、D组比较,差异有统计学意义(P <0.05),而B组甲减结果与C、A及D组比较,差异无统计学意义(P>0.05);4组甲状腺功能正常结果比较,差异无统计学意义(P>0.05)。结论治疗前TRAb阳性、TPOAb阴性的甲亢患者治疗后无效率高,而TRAb阴性、TPOAb阳性的甲亢患者治疗后甲减发生率高。
Objective To study the effect of thyroid autoantibodies on the clinical outcome of 131I treatment of hyperthyroidism. Methods A total of 194 cases of hyperthyroidism treated by 131I admitted to North China University of Science and Technology Affiliated Hospital from July 2016 to April 2017 were selected and divided into 4 groups based on the results of pretreatment thyroid autoantibodies. TRAb and TPOAb were negative in group A;TRAb was positive and TPOAb was negative in group B;TRAb was negative and TPOAb was positive in group C;TRAb and TPOAb were positive in group D. The relationship between different thyroid autoantibodies before treatment and clinical outcome after 131I treatment in patients with hyperthyroidism after 1 year follow-up. Results ① In patients with hyperthyroidism treated with 131I for 1 year, the effective rate was 80.4%, normal thyroid function rate was 52.0%, hypothyroidism rate (including subclinical hypothyroidism) was 28.4%, and ineffective hyperthyroidism rate (including subclinical hyperthyroidism) was 19.6%.② The composition ratio of clinical outcome of different thyroid autoantibodies in patients with hyperthyroidism after 131I treatment was different (P < 0.05).③ In this study,(R×C) chi-square test and Post hoc testing showed that the results of hyperthyroidism were statistically significant between group B, group D and group A and group C (P < 0.05) and there was no statistically significant difference between group B and group C, group A and group D (P < 0.05). For hypothyroidism, there was statistically significant difference between group B, group C and group A, group D, but there was no statistically significant difference between group B and group C, group A and group D;Thyroid function was normal and there was no statistical difference in the 4 groups. Conclusions Before treatment, patients with hyperthyroidism with positive TRAb and negative TPOAb have higher inefficiency after treatment, while patients with hyperthyroidism with negative TRAb and positive TPOAb have higher incidence of hypothyroidism after treatment.
作者
陈燕云
吴乃君
邹英楠
金思彤
于鹏
Yan-yun Chen;Nai-jun Wu;Ying-nan Zou;Si-tong Jin;Peng Yu(Department of Endocrinology, North China University of Science and Technology Affiliated Hospital,Tangshan, Hebei 063000, China)
出处
《中国现代医学杂志》
CAS
2019年第10期67-71,共5页
China Journal of Modern Medicine
