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目的探讨131I治疗甲状腺功能亢进症(甲亢)合并甲状腺功能亢进性肝病(甲亢性肝病)的效果。方法 58例甲亢合并甲亢性肝病患者均给予131I治疗,分别于治疗前及治疗3个月后检测促甲状腺激素(thyroid stimulating hormone,TSH)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、总三碘甲状腺原氨酸(total triiodothyronine,TT3)、总甲状腺素(total thyroxine,TT4)、谷丙转氨酶(glutamic-pyruvic transaminase,GPT),谷草转氨酶(glutamic-oxaloacetic transaminase,GOT)、碱性磷酸酶(alkaline phosphatase,ALP)、γ-谷氨酰转肽酶(γ-glutamyl transpeptadase,γ-GT)、总胆红素(total bilirubin,TBil)、直接胆红素(direct bilirubin,DBil)水平,并评定治疗后3个月疗效。结果 131I治疗3个月后患者血清TSH((1.84±0.64)mu/L)高于治疗前((0.01±0.00)mu/L)(P<0.01),FT3((5.12±1.75)pmol/L)、FT4((18.34±4.98)pmol/L)、TT3((2.75±1.98)nmol/L)、TT4((65.48±56.28)nmol/L)、GPT((35.10±29.15)u/L)、GOT((30.12±17.58)u/L)、ALP((83.21±45.46)u/L)、γ-GT((46.35±33.78)u/L)、TBil(13.25±4.97)μmol/L)、DBil((3.75±1.46)μmol/L)水平均较治疗前降低(FT3为(15.28±2.45)pmol/L、FT4为(57.58±8.91)pmol/L、TT3为(6.38±2.37)nmol/L、TT4为(245.17±62.14)nmol/L、GPT为(90.25±44.12)u/L、GOT为(55.38±30.27)u/L、ALP为(103.11±53.14)u/L、、γ-GT为(82.54±57.12)u/L、TBil为(15.98±8.49)μmol/L、DBil为(5.87±4.26)μmol/L)(P<0.01);治疗3个月后评定治疗效果,甲亢治愈率为43.10%(25/58)。结论 131I治疗甲亢合并甲亢性肝病效果满意,且可改善患者肝功能。
Objective To investigate the effect of 131I treatment of hyperthyroidism (hyperthyroidism) complicated with hyperthyroidism liver disease (hyperthyroidism liver disease). Methods A total of 58 hyperthyroidism patients with hyperthyroidism were treated with 131I. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3) Free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), glutamic-pyruvic transaminase (GPT), glutamic-aspartate aminotransferase -oxaloacetic transaminase (GOT), alkaline phosphatase (ALP), γ-glutamyl transpeptadase (γ-GT), total bilirubin (TBil) Direct bilirubin (DBil) levels, and assessed 3 months after treatment curative effect. Results Serum TSH (1.84 ± 0.64) mu / L after 131I treatment for 3 months was significantly higher than that before treatment (0.01 ± 0.00) mu / L and (5.12 ± 1.75) pmol / L ), TT4 ((18.34 ± 4.98) pmol / L), TT3 (2.75 ± 1.98) nmol / L and TT4 (65.48 ± 56.28) nmol / GOT was significantly higher than that of control group (30.12 ± 17.58) u / L, ALP 83.21 ± 45.46 u / L, γ-GT 46.35 ± 33.78 u / L and TBil 13.25 ± 4.97 μmol / L, (3.75 ± 1.46) μmol / L) were significantly lower than those before treatment (FT3 was (15.28 ± 2.45) pmol / L, FT4 was (57.58 ± 8.91) pmol / L and TT3 was (6.38 ± 2.37) nmol / TTT was 245.17 ± 62.14 nmol / L, GPT was 90.25 ± 44.12 u / L, GOT was 55.38 ± 30.27 u / L, ALP was 103.11 ± 53.14 u / L, γ-GT was ( 82.54 ± 57.12) u / L, TBil (15.98 ± 8.49) μmol / L and DBil (5.87 ± 4.26) μmol / L, P <0.01) .The therapeutic effect was evaluated after 3 months. The cure rate of hyperthyroidism was 43.10 % (25/58). Conclusion 131I treatment of hyperthyroidism with hyperthyroidism liver disease is satisfactory, and can improve liver function in patients.