[1]俞秀华,黄炜坤,林玉梅.131I治疗Graves病合并肝损害的临床观察[J].国际放射医学核医学杂志,2014,38(2):90-93.[doi:10.3760/cma.j.issn.1673-4114.2014.02.005]
　Yu Xiuhua,Huang Weikun,Lin Yumei.Clinical observation of 131I therapy in Graves disease patients with hepatic dysfunction[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(2):90-93.[doi:10.3760/cma.j.issn.1673-4114.2014.02.005]
点击复制

131I治疗Graves病合并肝损害的临床观察(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
38
期数:
2014年第2期
页码:
90-93
栏目:
出版日期:
2014-03-25

文章信息/Info

Title:
Clinical observation of 131I therapy in Graves disease patients with hepatic dysfunction
作者:
俞秀华;  黄炜坤;  林玉梅
福建医科大学附属龙岩第一医院核医学科, 龙岩 364000
Author(s):
Yu Xiuhua;  Huang Weikun;  Lin Yumei
Department of Nuclear Medicine, the Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
关键词:
格雷夫斯病; 肝; 近距离放射疗法; 碘放射性同位素
Keywords:
Graves disease; Liver; Brachytherapy; Iodine radioisotopes
DOI:
10.3760/cma.j.issn.1673-4114.2014.02.005
摘要:
目的 观察131I治疗Graves病合并肝损害患者的甲状腺激素水平和肝功能各项指标的变化,评价131I治疗的临床效果,为临床提供实践性指导。方法 回顾性分析101例接受131I治疗的Graves病合并肝损害患者的临床资料,对治疗前和治疗后3、6个月甲状腺激素水平和肝功能各项指标的变化进行分析。结果 患者经过131I治疗后6个月,甲状腺功能恢复正常者79例,明显好转者14例,甲状腺功能减退者8例;肝功能恢复正常者94例,好转者7例。131I治疗后3个月和6个月,所有患者甲状腺激素水平明显降低,TSH逐渐恢复,丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、碱性磷酸酶、γ-谷氨酰转移酶和总胆红素水平显著下降;治疗后3个月与治疗前、治疗后6个月与治疗后3个月甲状腺激素水平和肝功能各项指标分别进行比较,差异均有统计学意义(t=4.609~26.865,P均<0.01).结论 对于Graves病合并肝损害患者,131I治疗优于抗甲状腺药物治疗,当临床确诊Graves病合并肝损害时应首选131I治疗。
Abstract:
Objective To observe the changing of thyroid hormone levels and hepatic function indicators of Graves disease patients with hepatic dysfunction who undergoing 131I therapy,then to evaluate the therapeutic effect and provide practical guidance for clinic.Methods The clinical data of the 101 Graves disease patients with hepatic dysfunction who had received 131I therapy were analyzed retrospectively.Thyroid hormone levels arid hepatic function indices before treatment,3 and 6 months after treatment were analyzed.Results After followed up for 6 months,of all the 101 patients,thyroid function returned to normal in 79 cases; 14 cases improved markedly; 8 cases progressed in hypothyroidism.Liver function returned to normal in 94 cases and liver function improved in 7 cases.Three and six months after 131I therapy,thyroid hormones levels of all the patients decreased significantly,and TSH restored gradually.Alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,γ-glutamyltransferanse and total bilirubin level were significantly decreased.Comparison of thyroid hormones and hepatic function indices of patients 3 months after treatment vs.the values before treatment and 6 months after treatment vs. 3 months after treatment,the differences were statistically significant (t=4.609~26.865,P<0.01).Conclusion 131I therapy is better than antithyroid drugs treatment,it should be the first choice for Graves disease patients with hepatic dysfunction.

参考文献/References:

[1] 陆再英,钟南山.内科学[M].7版.北京:人民卫生出版社,2008:717.
[2] 蒋宁一,匡安仁,谭建,等.131I治疗Graves甲亢专家共识(2010年)[J].中华核医学杂志,2010,30(5):346-351.
[3] 李林.131I治疗Graves病概述//潘中允.放射性核素治疗学[M].北京:人民卫生出版社,2006:93.
[4] 闫瑞红,周振虎,张玉芳,等.131I与131I联合保肝药物治疗Graves甲亢合并肝损害的疗效比较[J].中华核医学与分子影像杂志,2012,32(4):269-272.
[5] 李文华,袁刚,赵西平.甲状腺功能亢进症与肝损害[J].内科急危重症杂志,2010,16(1):8-12.
[6] 蔡敏,李险峰,冯小妍,等.131I对Graves病患者甲状腺细胞凋亡的影响[J].中华核医学杂志,2011,31(1):54-57.
[7] 邢家骝,朱家瑞,丁勇.碘-131治疗甲状腺疾病[M].2版.北京:人民卫生出版社,2011:169.

相似文献/References:

[1]梁雯丽,郑艳,李娜,等.Graves甲亢患者131I治疗后早期TRAb及TSAb变化的研究分析[J].国际放射医学核医学杂志,2016,40(1):13.[doi:10.3760/cma.j.issn.1673-4114.2016.01.003]
　Liang Wenli,Zheng Yan,Li Na,et al.Analysis of the changes in early TRAb and TSAb after 131I treatment for patients with Graves hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(2):13.[doi:10.3760/cma.j.issn.1673-4114.2016.01.003]
[2]田琦,蒋宁一,郑丽.265例精细个体化131I治疗Graves甲亢的疗效观察[J].国际放射医学核医学杂志,2016,40(4):259.[doi:10.3760/cma.j.issn.1673-4114.2016.04.004]
　Tian Qi,Jiang Ningyi,Zheng Li.Therapeutic effect of fine individual 131I treatment on Graves disease hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(2):259.[doi:10.3760/cma.j.issn.1673-4114.2016.04.004]
[3]王越,晋建华,李思进,等.甲状腺24h摄碘率与131I治疗Graves甲亢疗效相关性研究[J].国际放射医学核医学杂志,2015,39(6):442.[doi:10.3760/cma.j.issn.1673-4114.2015.06.002]
　Wang Yue,Jin Jianhua,Li Sijin,et al.Correlation between thyroid 24 h of radioactive iodine uptake and clinical efficacy of 131I therapy for Graves’ hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(2):442.[doi:10.3760/cma.j.issn.1673-4114.2015.06.002]
[4]张丽花,蒋宁一.131I治疗Graves甲亢合并肝功能损害或血细胞减少的优势与风险[J].国际放射医学核医学杂志,2015,39(6):483.[doi:10.3760/cma.j.issn.1673-4114.2015.06.010]
　Zhang Lihua,Jiang Ningyi.The advantage and risk of 131I treatment in hyperthyroidism combined with liver injury or blood cell reduction[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(2):483.[doi:10.3760/cma.j.issn.1673-4114.2015.06.010]
[5]胡小春,蒋宁一,李敬彦,等.硒对经131I治疗Graves病患者血清甲状腺过氧化物酶抗体水平的影响[J].国际放射医学核医学杂志,2015,39(2):140.[doi:10.3760/cma.j.issn.1673-4114.2015.02.008]
　Hu Xiaochun,Jiang Ningyi,Li Jingyan,et al.Effect of additional selenium on the levels of serum thyroid peroxidase antibody in patients with Graves disease treated with 131I[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(2):140.[doi:10.3760/cma.j.issn.1673-4114.2015.02.008]
[6]查金顺,蒋艳,徐源,等.131I辅以短期小剂量碳酸锂治疗Graves甲亢的研究[J].国际放射医学核医学杂志,2014,38(1):10.[doi:10.3760/cma.j.issn 1673-4114.2014.01.003]
　Zha Jinshun,Jiang Yah,Xu Yuan,et al.Clinical research on radioiodine addition of low-doses of lithium carbonate in short-term treatment of Graves hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(2):10.[doi:10.3760/cma.j.issn 1673-4114.2014.01.003]
[7]王深,孟召伟,贾强,等.MRI弥散加权成像、甲状腺摄碘率和血清指标测定鉴别Graves甲状腺功能亢进症和无痛性甲状腺炎的研究[J].国际放射医学核医学杂志,2014,38(6):392.[doi:10.3760/cma.j.issn.1673-4114.2014.06.011]
　Wang Shen,Meng Zhao-wei,Jia Qiang,et al.Differentiation between Graves disease and painless thyroiditis by diffusion-weighted imaging, thyroid radioactive iodine uptake and serum parameters measurement[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(2):392.[doi:10.3760/cma.j.issn.1673-4114.2014.06.011]
[8]郑艳,赵德善,付松海,等.儿童和青少年Graves甲亢患者131Ⅰ治疗剂量的分析研究[J].国际放射医学核医学杂志,2013,37(2):69.[doi:10.3760/cma.j.issn.1673-4114.2013.02.002]
　ZHENG Yan,ZHAO De-shan,FU Song-hai,et al.The dose analysis of 131Ⅰ treatment in pediatric patients with Graves hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(2):69.[doi:10.3760/cma.j.issn.1673-4114.2013.02.002]
[9]王朝点,史育红,颜兵.TRAb水平测定在Graves眼病中的临床意义探讨[J].国际放射医学核医学杂志,2013,37(2):77.[doi:10.3760/cma.j.issn.1673-4114.2013.02.004]
　WANG Chao-dian,SHI Yu-hong,YAN Bing.The clinical value of serum thyrotrophin receptor antibody level in patients with Graves ophthalmopathy[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(2):77.[doi:10.3760/cma.j.issn.1673-4114.2013.02.004]
[10]张瑞国,秦岚,张又萍,等.初诊Graves甲亢合并肝损害及其影响因素的临床分析[J].国际放射医学核医学杂志,2013,37(5):283.[doi:10.3760/cma.j.issn.1673-4114.2013.05.008]
　ZHANG Rui-guo,QIN Lan,ZHANG You-ping,et al.Clinical study of hepatic dysfunction and its correlative factors in newly diagnosed patients with Graves hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(2):283.[doi:10.3760/cma.j.issn.1673-4114.2013.05.008]

备注/Memo

备注/Memo:
收稿日期:2013-05-18;改回日期:。
通讯作者:俞秀华(Email:vuxiuhua198@sina.com)
更新日期/Last Update: 1900-01-01