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目的:分析131I治疗甲状腺功能亢进(简称甲亢)后早发甲状腺功能减退(简称甲低)的临床特点和远期随访结果。方法:对150例131I治疗甲亢后1年内出现甲低的患者进行临床分析,并对其中120例进行门诊随访1～5年,平均3年。结果:(1)暂发性甲低组40例,占33.33%,其中1年内甲状腺功能恢复正常者28例,再发甲亢者12例。远期随访显示,甲状腺功能正常者有5例在1～4年后出现甲低;甲亢者中有6例在3个月～2年甲状腺功能恢复正常,4例在3个月～2年后出现永久性甲低。(2)永久性甲低组80例,占66.67%,其中95%(76例)在131I治疗后1～6个月出现甲低;有临床症状者占85%(68例);有用小剂量131I(≤185MBq)者占83.75%(67例)。结论:早发甲低中多为永久性甲低,后者中服用小剂量131I治疗者多;暂发性甲低的转归不能用于预测以后的甲状腺功能。
Objective: To analyze the clinical features and long-term follow-up of early hypothyroidism (hypothyroidism) after 131I treatment of hyperthyroidism (referred to as hyperthyroidism). Methods: Clinical analysis of 150 patients with hypothyroidism within 1 year after 131I treatment of hyperthyroidism was performed. Outpatients were followed up for 1 to 5 years for 120 cases, with an average of 3 years. Results: (1) 40 cases were transient hypothyroidism, accounting for 33.33%. Among them, 28 cases had normal thyroid function recovery in one year and 12 cases had hyperthyroidism recurrence. Long-term follow-up showed that in 5 patients with normal thyroid function, hypothyroidism occurred after 1 to 4 years. In 6 patients with hyperthyroidism, thyroid function returned to normal within 3 months to 2 years and in 4 patients after 3 months to 2 years A permanent low appears. (2) 80 cases of permanent hypothyroidism, accounting for 66.67%, of which 95% (76 cases) showed hypothyroidism 1 to 6 months after 131I treatment; 85% (68 cases) had clinical symptoms; 131I (≤ 185MBq) accounted for 83.75% (67 cases). CONCLUSIONS: Early hypothyroidism is mostly permanent hypothyroidism, while the latter is treated with a small dose of 131I treatment; transient hypothyroidism can not be used to predict subsequent thyroid function.