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目的研究甲状腺过氧化物酶抗体(TPOAb)水平对毒性结节性甲状腺肿(毒性结甲)患者131I治疗后不同转归的影响,探讨其是否对治疗后甲状腺功能减低具有指示作用。方法依照血清TPOAb水平,将103例毒性结甲患者分为阳性组(66例)和阴性组(37例),并且定期检测治疗后血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平,判断患者的甲状腺功能变化情况。结果131I治疗一年后,甲状腺功能减退症(包含亚临床甲状腺功能减退)的发生率阳性组为28.8%、阴性组为8.1%,且两组间甲减发生率差异有统计学意义(χ2=6.04,P<0.05)。结论(1)毒性结甲131I治疗前血清TPOAb水平与治疗后甲减的发生率有关。(2)血清TPOAb水平可作为治疗后甲减发生的预警指标,毒性结甲131I治疗核素剂量可以根据其水平进行调整。
Objective To investigate the effect of thyroid peroxidase antibody (TPOAb) level on the outcome of 131I patients after toxic nodular goiter (toxic nodular goiter), and to explore whether it has an indicator of hypothyroidism after treatment. Methods According to the level of serum TPOAb, 103 patients with toxic nodules were divided into positive group (66 cases) and negative group (37 cases), and serum levels of free triiodothyronine (FT3), free thyroxine FT4), thyroid stimulating hormone (TSH) levels, to determine the patient’s thyroid function changes. Results One year after 131I treatment, the incidence of hypothyroidism (including subclinical hypothyroidism) was 28.8% in the positive group and 8.1% in the negative group, and the difference in the incidence of hypothyroidism was statistically significant (χ2 = 6.04, P <0.05). Conclusions (1) Toxicity of 131I before treatment with serum TPOAb levels and the incidence of hypothyroidism after treatment. (2) Serum levels of TPOAb can be used as an early warning indicator of hypothyroidism after treatment, toxicity of 131I treatment nuclide dose can be adjusted according to its level.