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目的观察甲亢131碘治疗后早发甲减患者甲状腺功能的变化。方法①Graves病甲亢行131I治疗后6月内出现甲低的患者206例,男67例,女139例,根据甲功三项(FT3、FT4、TSH)随访分成两组。暂发甲低组:甲功恢复正常或甲亢。永久甲低组:需左旋甲状腺素替代治疗。②治疗前测定甲状腺功能、甲状腺吸131I率和甲状腺显像。131I治疗剂量(MBq)=甲状腺质量(g)×每克甲状腺给予的剂量/甲状腺24 h吸131I率(%)。③用SPSS14.0统计软件,分别计算两组甲低发生率;两组年龄,病程,治疗前甲状腺大小,甲状腺功能(FT3,FT4,TSH,TGA,MCA),甲状腺吸131I率,每克甲状腺131I剂量、131I总剂量比较用t检验,P﹤0.05为差异有统计学意义。结果①206例早发性甲低患者中,暂发甲低组:55例,占26.7%;永久性甲低组:151例,占73.3%;②两组比较年龄,病程,甲状腺大小,治疗前甲状腺功能,甲状腺吸碘功能,每克甲状腺剂量、总剂量差异均无统计学意义(P﹥0.05)。结论早发甲低患者大多数可能成为永久性甲低,早发甲低的转归不能预测。甲亢131碘治疗后应监测甲状腺功能,长期随访。
Objective To observe the changes of thyroid function in patients with early hypothyroidism after 131I treatment of hyperthyroidism. Methods ① Graves disease hyperthyroidism line 131I after treatment within 6 months, there are 206 cases of hypothyroidism, 67 males and 139 females, according to the three functions of thyroid (FT3, FT4, TSH) were divided into two groups. Temporary low arm: Jia Gong returned to normal or hyperthyroidism. A permanent low group: L-thyroid hormone replacement therapy is required. ② Determination of thyroid function before treatment, 131I thyroid suction rate and thyroid imaging. 131I therapeutic dose (MBq) = thyroid mass (g) x dose administered per gram of thyroid / 131I rate (%) of thyroid 24 h. ③The incidence of hypothyroidism in both groups was calculated by SPSS14.0 statistical software. The age, course of disease, thyroid size before treatment, thyroid function (FT3, FT4, TSH, TGA, MCA) 131I dose, total dose of 131I compared with t test, P <0.05 for the difference was statistically significant. Results ① Among the 206 patients with early-onset hypothyroidism, 55 cases were transient hypothyroidism, accounting for 26.7%; 151 cases were permanent hypothyroidism, accounting for 73.3%; ② The age, course of disease, thyroid size, Thyroid function, thyroid function of iodine uptake, per gram of thyroid dose, total dose differences were not statistically significant (P> 0.05). Conclusions Most patients with early hypothyroidism may become permanent hypothyroidism, and the prognosis of early hypothyroidism can not be predicted. Thyroid function should be monitored after hyperthyroidism 131 iodine treatment, long-term follow-up.