[1]林琛,王鲁华,李俊雄,等.131Ⅰ治疗Graves’甲状腺亢进症伴白细胞减少前后血清和尿中β2-微球蛋白变化分析[J].国际放射医学核医学杂志,2007,31(2):98-101.
　LIN Chen,WANG Lu-hua,LI Jun-xiong,et al.Changes of serum and urine β2-microglobulin of leukopenia in hyperthyroidism of Graves’ disease before and after 131Ⅰ therapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2007,31(2):98-101.
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131Ⅰ治疗Graves’甲状腺亢进症伴白细胞减少前后血清和尿中β2-微球蛋白变化分析(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
31
期数:
2007年第2期
页码:
98-101
栏目:
临床核医学
出版日期:
1900-01-01

文章信息/Info

Title:
Changes of serum and urine β2-microglobulin of leukopenia in hyperthyroidism of Graves’ disease before and after 131Ⅰ therapy
作者:
林琛;  王鲁华;  李俊雄;  欧阳亮;  关楚文
515041 汕头, 汕头大学医学院第一附属医院核医学科
Author(s):
LIN Chen;  WANG Lu-hua;  LI Jun-xiong;  OU YANG-Liang;  GUAN Chu-wen
Department of Nuclear Medition, The First Affiliated Hospital of Shan Tou University Medical College, Guangdong Shantou 515041, China
关键词:
Graves’病; 白细胞; 放射疗法; 甲状腺激素类; 碘放射性同位素; β2-微球蛋白
Keywords:
Graves’ disease; Leucocyte; Radiotherapy; Thyroid hormones; Iodine radioisotopes; β2-microglobulin
分类号:
R446
摘要:
目的 探讨131Ⅰ治疗Graves’甲亢伴白细胞减少的价值及对β2-微球蛋白(β2-MG)水平的影响。方法 采用化学发光免疫分析测定患者131Ⅰ治疗前和131Ⅰ治疗后3个月及6个月空腹血的游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3);采用放射免疫分析测定血清及尿液β2-MG,同时测定治疗前血清尿素氮(BUN)及肌酐(Cr)。结果 131Ⅰ治疗Graves’甲亢伴白细胞减少的一次性治愈率、好转率、无效率及甲减发生率分别为76.7%(23/30)、13.3%(4/30)、3.3%(1/30)、6.7%(2/30),总有效率为96.7%。131Ⅰ治疗前β2-MG与FT3、FT4水平显著高于对照组(P<0.01),白细胞水平低于对照组(P<0.05)。131I治疗后3个月FT3、FT4水平与131I治疗前对比,P<0.01,白细胞及β2-MG水平与治疗前比较,P<0.05。131Ⅰ治疗后6个月FT3、FT4及β2-MG水平与131Ⅰ治疗前对比,P<0.01;白细胞水平与治疗前比较,P<0.05,与对照组无显著性差异(P>0.05)。131I治疗前血清BUN及Cr与对照组比较无统计学意义(P>0.05)。β2-MG与FT3和FT4水平呈显著正相关。结论 131Ⅰ治疗Graves’甲亢合并白细胞减少是较为理想的一种治疗方法,β2-MG可作为131Ⅰ治疗Graves’甲亢伴白细胞减少症的疗效观察、病情变化及预后判断的一项辅助诊断指标。
Abstract:
Objective To investigate the value of 131Ⅰ therapy and the changes of the serum, urine contents of β2-microglobulin(β2-MG)in leukopenia in patients with Graves’ disease before and after 131Ⅰ therapy. Methods Serum and urine β2-MG contents (with radioimmunoassay), serum free triiodothyronine (FT3) and free tetraiodothyronine (FT4) lever (with chemiluminescence immunoassay) were determined before and after 131Ⅰ therapy. At the same time, measure blood ured nitrogen (BUN) and creatine (Cr) Results The cure rate, improvement, invalid, hypothyroidiam and total effective rate of 131Ⅰ therpy are 76.7%, 13.3%, 3.3%, 6.7%, 96.7% respectively. The serum and urine β2-MG contents as well as the serum FT3, FT4 levels in the 30 patients before treatment were significantly higher than those in the controls (P<0.01). While leucocyte was significantly lower than those in the control (P<0.05). After 3 months treatment, their FT3, FT4 levels lower than before treatment (P<0.01),[32-MG levels lower (vs before treatment, P<0.05), leucocyte increased (vs before treatments, P<0.05). After 6 months treatment, their β2-MG,FT3,FT4 levels dropped to approaching normal (vs controls, P>0.05 and vs before treatments, P<0.01). Both BUN and Cr of the controls and before treatment groups have no big difference. The serum FT3, FT4 level was positively correlative to the β2-MG (P<0.05). Conclusions 131Ⅰ therapy is an ideal treatment for Graves’ hyperthyroidism, which have many advantages. β2-MG could be used as a diagnostic indicator for leukopenia in patients with Graves’ disease.

参考文献/References:

1 谭天秩.131Ⅰ治疗甲状腺功能亢进症.见:中华人民共和国卫生部医政司主编.核医学诊断与治疗规范.北京:科学出版社,1997.285-287.
2 罗晓尧.临床内分泌疾病手册.上海:上海科技教育出版社,2001.74.
3 斯徐伟,詹乾钢,朱麒钱,等.外周血CD4+B细胞变化与Graves病病情活动性相关.中华内分泌代谢杂志,2006,22(2):121-122.

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备注/Memo

备注/Memo:
收稿日期:2006-12-30。
通讯作者:林琛(E-mail:569137168@qq.con)
更新日期/Last Update: 1900-01-01