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目的:比较131I与抗甲状腺药物(ATD)治疗甲亢性心脏病的临床疗效。方法:对226例甲亢性心脏病患者分别采用131I(151例)及ATD(75例)治疗,比较两组病例的临床疗效、治疗前后甲状腺激素水平、心电图及超声心动图变化情况。结果:131I组的总有效率显著高于ATD组(P<0.01);且心功能改善及心电图好转率均显著高于ATD组(均P<0.01)。超声心动图检查:131 I组患者LVEF、LVEDD、LVESD、SV及CO治疗后较治疗前显著改善(P<0.01);ATD组治疗前后差异无统计学意义;治疗后两组指标相比差异有统计学意义(P<0.01)。两组治疗后甲状腺激素水平较治疗前均显著降低(P<0.01),但两组治疗后甲状腺激素水平相比无统计学意义。131I组甲状腺功能减退(甲减)发生率显著高于ATD组(17%vs.0%,P<0.01)。结论:131I治疗甲亢性心脏病综合疗效优于ATD,缺点是甲减发生率高。
Objective: To compare the clinical efficacy of 131I and antithyroid drugs (ATD) in the treatment of hyperthyroid heart disease. Methods: A total of 226 patients with hyperthyroid heart disease were treated with 131I (151 cases) and ATD (75 cases) respectively. The clinical efficacy, thyroid hormone level, ECG and echocardiography were compared between the two groups before and after treatment. Results: The total effective rate of 131I group was significantly higher than that of ATD group (P <0.01). The improvement of cardiac function and electrocardiogram rate were significantly higher than that of ATD group (all P <0.01). Echocardiography examination showed that LVEF, LVEDD, LVESD, SV and CO in 131 I group were significantly improved after treatment (P <0.01), but there was no significant difference in ATD group before and after treatment Statistical significance (P <0.01). The levels of thyroid hormone in both groups were significantly lower than those before treatment (P <0.01), but there was no significant difference between the two groups in thyroid hormone levels after treatment. The incidence of hypothyroidism (hypothyroidism) in 131I group was significantly higher than that in ATD group (17% vs.0%, P <0.01). Conclusion: 131I treatment of hyperthyroidism heart disease better than ATD, the disadvantage is the high incidence of hypothyroidism.