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目的:观察131I治疗甲状腺机能亢进症的近远期疗效,分析发生早晚期甲状腺机能减退症的因素。方法:对在本院核医学科进行131I治疗的甲状腺机能亢症进患者232例进行随访,随访时间5年,从病理基础和自身抗体等方面对比观察131I治疗对早晚发甲状腺机能减退症的影响及预后。结果:抗体阳性(抗甲状腺球蛋白抗体、抗微粒体抗体中1项阳性,该病例记为阳性)占所有早发甲状腺功能减退症的73.68%,与抗体阴性者相比差异有统计学意义(P<0.01)。早发甲状腺功能亢进中毒性弥漫性甲状腺肿16例,占84.2%(16/19),而在晚发甲状腺功能减退中占82.3%(28/34),在早发或晚发甲状腺功能减退中,毒性弥漫性甲状腺肿与结节性甲状腺肿发病率相比差异均有统计学意义(P<0.01)。结论:甲状腺自身抗体阳性是131I治疗后甲状腺功能减退发生的独立危险因素,毒性弥漫性甲状腺肿一般较结节性甲状腺肿更容易发生早发和晚发甲状腺功能减退。
Objective: To observe the short-term and long-term effects of 131I in the treatment of hyperthyroidism and to analyze the factors of early and late hypothyroidism. Methods: A total of 232 hyperthyroidism patients who underwent 131I treatment in our hospital were followed up for 5 years. The effects of 131I therapy on hypothyroidism and hypothyroidism were observed by pathology and autoantibodies And prognosis. Results: The antibody positive (one of anti-thyroglobulin antibody and anti-microsomal antibody was positive), which accounted for 73.68% of all cases with hypothyroidism, and the difference was statistically significant compared with that of antibody negative P <0.01). 16 cases of early onset hyperthyroidism toxic diffuse goiter, accounting for 84.2% (16/19), while in late hypothyroidism accounted for 82.3% (28/34), in early or late hypothyroidism There was significant difference in the incidence of diffuse goiter and nodular goiter (P <0.01). Conclusion: The positive thyroid autoantibodies are independent risk factors for thyroid hypothyroidism after 131I treatment. Venous diffuse goiter is more likely to develop early and late hypothyroidism than nodular goiter.