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中国临床研究英文版:2018,31(6):793-795
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Graves 病I-131 治疗后促甲状腺激素不同控制水平永久性甲状腺功能减退症发生率比较
(1.河北北方学院研究生部,河北 张家口 075000;2.河北北方学院附属第一医院内分泌科,河北 张家口 075000)
Effect of 131I treatment for Graves′ disease on TSH cutoff level and incidence of permanent hypothyroidism
摘要
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Received:December 18, 2017   Published Online:June 21, 2018
中文摘要: 目的 观察Graves病(GD) 患者碘-131(131I)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131I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131I治疗1年后永久性发甲减发生率。结果 131I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(χ2=5.185,P<0.05)。结论 GD患者131I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131I 治疗后永久性甲减的发生率。
Abstract: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(131I) for 3 months. Methods Seventy patients diagnosed as hypothyroidism by rechecking thyroid function 3 months after 131I 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 131I for one year. Results After treatment with 131I for one year, the incidence of permanent hypothyroidism was 88. 6% in group A and 65. 7% in group B(χ2=5.185, P<0.05). Conclusion In early-onset hypothyroidism patients with GD treated with 131I 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.
文章编号:     中图分类号:R 581.2    文献标志码:B
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