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目的探讨Graves病患者治疗前后血尿β2-微球蛋白(β2-M)及尿微量白蛋白(Alb)的变化,了解放射性131I治疗对Graves病患者肾功能的影响。方法采用放射免疫分析法(RIA)测定45例健康志愿者及84例Graves病患者血、尿β2-M及尿Alb水平,进行对比分析。84例Graves病患者在自愿选择知情同意后略有调整的分为他巴唑治疗组和放射性131I治疗组。结果治疗前Graves病2组患者血、尿β2-M水平及尿Alb水平均明显高于对照组(P均<0.01)。治疗1.5年后,血β2-M水平较治疗前明显降低(P均<0.01),但2组间无统计学差异(P>0.05)。他巴唑治疗组治疗1.5年后尿β2-M及尿Alb较治疗前均明显下降(P均<0.01),与对照组无统计学差异(P>0.05)。放射性131I治疗组治疗1.5年后,尿β2-M及尿Alb较治疗前均明显下降(P均<0.01),且明显高于对照组(P均<0.01)。治疗1.5年后,血清T3、T4水平放射性131I治疗组明显低于他巴唑组和对照组(P均<0.05),血清TSH水平放射性131I治疗组明显高于他巴唑组和对照组(P均<0.05)。结论 Graves病患者存在肾脏损害,在抗甲状腺机能亢进治疗后的肾脏损害恢复方面,他巴唑治疗优于放射性131I治疗组。
Objective To investigate the changes of hematuria β2-microglobulin (β2-M) and urinary albumin (Alb) in patients with Graves ’disease before and after treatment, and to understand the effects of radioactive 131I therapy on renal function in patients with Graves’ disease. Methods Radioimmunoassay (RIA) was used to detect the levels of blood and urinary β2-M and urinary Alb in 45 healthy volunteers and 84 patients with Graves disease. Eighty-four patients with Graves’ disease were divided into the methimazole group and the radioactive 131I group with a slight adjustment after their voluntary informed consent. Results The levels of blood and urinary β2-M and urinary Alb in Graves’ disease group before treatment were significantly higher than those in control group (all P <0.01). After treatment for 1.5 years, blood β2-M levels were significantly lower than those before treatment (all P <0.01), but there was no significant difference between the two groups (P> 0.05). In the methimazole treatment group, urinary β2-M and urinary Alb decreased significantly after treatment for 1.5 years (all P <0.01), showing no significant difference from the control group (P> 0.05). Radioactive 131I treatment group 1.5 years after treatment, urinary β2-M and urine Alb than before treatment were significantly decreased (P all <0.01), and significantly higher than the control group (P all <0.01). After treatment for 1.5 years, the level of serum T3 and T4 radioactive iodine 131I treatment group was significantly lower than the methimazole group and the control group (P all <0.05), serum TSH levels of radioactive 131I treatment group was significantly higher than the methimazole group and the control group (P All <0.05). Conclusions There is kidney damage in patients with Graves’ disease, and it is superior to radioactive 131I in the treatment of kidney damage after antihypertensive treatment.