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目的探讨硒联合小剂量~(131)I治疗Graves甲状腺功能亢进(甲亢)的临床疗效。方法收集2012年9月~2014年10月河南省疾病预防控制中心甲状腺病门诊收治的132例Graves甲亢患者,随机分为观察组(70例)和对照组(62例),观察组经~(131)I治疗后行常规治疗及每天服用200μg亚硒酸钠,服用1年;对照组经131I治疗后行常规治疗。分别于治疗后3、6、9、12个月测定血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)。结果治疗后12个月,观察组70例Graves甲亢患者治愈60例,治愈率85.7%;对照组62例患者治愈51例,治愈率82.3%,两组间比较差异无统计学意义(χ~2=0.294,P>0.05)。观察组3例出现一过性甲状腺功能减退症,发生率为4.3%;对照组10例出现一过性甲状腺功能减退症(甲减),发生率为16.1%,明显高于观察组,两组间比较差异有统计学意义(χ~2=5.194,P<0.05)。观察组无永久性甲减发生;对照组有3例发展为永久性甲减,给予甲状腺片替代治疗。结论硒联合小剂量~(131)I治疗Graves甲亢可降低一过性甲状腺功能减退症的发生率。
Objective To investigate the clinical effect of selenium combined with low dose 131I treatment on Graves hyperthyroidism (hyperthyroidism). Methods Thirty-two patients with Graves’ hyperthyroidism who were admitted to the Thyroid Disease Clinic of Henan Center for Disease Control and Prevention from September 2012 to October 2014 were randomly divided into observation group (70 cases) and control group (62 cases) 131) I after conventional treatment and taking 200μg daily sodium selenite, taking 1 year; control group after 131I treatment routine. Serum thyrotropin (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured at 3, 6, 9 and 12 months after treatment. Results In the 12 months after treatment, 70 cases of Graves hyperthyroidism were cured in 60 cases, the cure rate was 85.7%. In control group, 62 cases were cured in 51 cases, the cure rate was 82.3%. There was no significant difference between the two groups (χ ~ 2 = 0.294, P> 0.05). The incidence of transient hypothyroidism was 4.3% in 3 cases in observation group. The incidence of transient hypothyroidism (hypothyroidism) in 10 cases in control group was 16.1%, which was significantly higher than that in observation group. Both groups The difference was statistically significant (χ ~ 2 = 5.194, P <0.05). There was no permanent hypothyroidism in the observation group. In the control group, 3 patients developed permanent hypothyroidism and were given thyroid replacement therapy. Conclusion Selenium combined with low dose 131I treatment of Graves hyperthyroidism can reduce the incidence of transient hypothyroidism.