| 李玉娟,祁 岗,李海燕,李梦婕,吴葆华.碘131与他巴唑治疗甲状腺功能亢进症的临床疗效比较[J].,2018,(20):3933-3936 |
| 碘131与他巴唑治疗甲状腺功能亢进症的临床疗效比较 |
| Comparison of the Clinical Efficacy of Iodine 131 and Methimazole in the Treatment of Hyperthyroidism |
| 投稿时间：2018-02-24 修订日期：2018-03-19 |
| DOI：10.13241/j.cnki.pmb.2018.20.030 |
| 中文关键词: 碘131 他巴唑 甲状腺功能亢进症 疗效 不良反应 |
| 英文关键词: Iodine 131 Methimazole Hyperthyroidism Efficacy Adverse reactions |
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| 中文摘要: |
| 摘要 目的：观察和比较碘131与他巴唑治疗甲状腺功能亢进症的临床疗效及安全性。方法：选取2012年1月至2016年1月于我院确诊并治疗的甲状腺功能亢进患者282例，根据随机数字表法分为碘131治疗组和药物治疗组，碘131治疗组采用131I进行治疗，药物治疗组采用他巴唑口服治疗。比较两组患者的临床疗效，治疗前后血清TSH(thyroid stimulating hormone，促甲状腺激素)、FT(free triiodothyronine，游离三碘甲状腺原氨酸)、FT4(free thyroxine concentration assay，血清游离甲状腺素)水平及TRAb(TRAB thyrotropin receptor antibodies, 促甲状腺激素受体抗体)阳性率的变化及治疗期间不良反应的发生情况(心功能、肝功能、肾功能、甲状腺功能下降、白细胞减少)，并对患者进行6个月的随访，记录和比较患者甲亢复发情况。结果：治疗后，碘131治疗组的总有效率为92.9%，显著高于药物治疗组(64.5%，P＜0.05)；两组患者血清TSH水平较治疗前显著升高，而血清FT3、FT4水平及TRAb阳性率均较治疗前显著降低(P＜0.05)，且碘131治疗组血清TSH水平明显高于碘131治疗组，而血清FT3、FT4水平及TRAb阳性率明显低于碘131治疗组(P＜0.05)；碘131治疗组复发率及总不良反应发生率均明显低于药物治疗组(P＜0.05)。结论：碘131对甲状腺功能亢进症的疗效优于他巴唑口服治疗，可明显增加血清TSH水平，降低血清FT3、FT4水平及TRAb阳性率，且患者复发率及不良反应发生率均较低。 |
| 英文摘要: |
| ABSTRACT Objective: To observe and compare the clinical efficacy and safety of iodine 131 in the treatment of hyperthyroidism. Methods: 282 cases of patients with hyperthyroidism diagnosed and treated in our hospital from January 2012 to January 2016 were randomly divided into the iodine 131 treatment group and the drug treatment group according to the random number table method. Iodine 131 treatment group was treated with 131I, the drug treatment group was given oral administration of methimazole. The clinical efficacy, serum TSH, FT and FT4 levels, TRAb positive rate and incidence of adverse effects(cardiac function, liver function, renal function, decreased thyroid function, leukopenia) of patients in two groups during treatment were observed and compared, and patients were followed up for 6 months to record the recurrence. Results: After treatment, the total effective rate of iodine 131 treatment group was 92.9%, which was significantly higher than that of drug treatment group (64.5%, P<0.05); the levels of serum TSH were significant higher than before treatment, while the FT3, FT4 and TRAb positive rate were significantly decreased(P<0.05), the recurrence rate and incidence of adverse events in iodine 131 treatment group was significantly lower than that of drug treatment group (P<0.05). Conclusion: Iodine 131 had better clinical efficacy in the treatment of hyperthyroidism than oral tapazol therapy, it could significantly increase the serum TSH level, reduce the serum FT3, FT4 levels and TRAb positive rate, lower the recurrence rate and the incidence of adverse reactions. |
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