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目的了解甲状腺功能亢进症(甲亢)病人131I治疗前后骨质含量的变化。方法甲亢病人69例,131I治疗后3个月治愈24例,好转19例,甲状腺功能减退(甲减)14例,无效12例;治疗后6个月后治愈34例,好转10例,甲减18例,无效7例,治愈、好转及甲减为治疗有效者。应用双能X线骨密度仪,测定131I治疗前、治疗后3个月及6个月病人一侧股骨颈、ward’s三角、大转子和L2、L3、L4部位骨密度。以30例健康体检者作为对照组。结果治疗3、6个月治愈组ward’s三角、大转子、L2、L3、L4等5个部位治疗前骨密度均低于对照组,差异有显著性(t=2.635~4.479,P<0.05)。治疗3个月好转组ward’s三角、大转子、L3、L4等4个部位治疗前骨密度低于对照组,差异有显著性(t=2.156~4.390,P<0.05);治疗6个月好转组ward’s三角、大转子2个部位,甲减组ward’s三角、大转子、L2、L3、L4等5个部位治疗前骨密度低于对照组,差异有显著性(t=2.150~3.134,P<0.05)。治疗后6个月治疗有效组(包括治愈、好转和甲减组)各部位骨密度均高于治疗前,差异有显著性(t=2.579~12.008,P<0.05);与对照组比较,治疗有效组各部位(治愈组L3部位除外)骨密度差异无显著性(P>0.05)。结论随着时间的延长,甲亢131I治疗有效者骨质改善部位数逐渐增多。
Objective To investigate the changes of bone mass before and after 131I treatment in patients with hyperthyroidism (hyperthyroidism). Methods Ninety-nine patients with hyperthyroidism were cured, 24 cases were cured 3 months after 131I treatment, 19 cases were improved, 14 cases were hypothyroidism (hypothyroidism) and 12 cases were ineffective. After 6 months, 34 cases were cured, 10 cases improved, hypothyroidism 18 cases, 7 cases were ineffective, cured, improved and hypothyroidism for the treatment of effective. The BMD of the femoral neck, ward’s trigone, the greater trochanter and L2, L3 and L4 at one side before and after 131I treatment were measured by dual energy X-ray absorptiometry. 30 healthy people as control group. Results The bone mineral density of ward’s trigone, big trochanter, L2, L3 and L4 in the cured group was lower than that of the control group 3 months and 6 months after treatment (t = 2.635-4.479, P <0.05). At 3 months after treatment, the bone mineral density in ward’s triangle, big trochanter, L3 and L4 were lower than those in control group (t = 2.156 ~ 4.390, P <0.05) The BMD of ward’s trigone, trochanter, L2, L3, L4 and other five sites before treatment were lower than those of the control group, with significant difference (t = 2.150-3.1334, P <0.05) ). At 6 months after treatment, the BMD of each group in treatment effective group (including cure, improvement and hypothyroidism group) was significantly higher than that before treatment (t = 2.579-12.008, P <0.05). Compared with the control group, There was no significant difference in BMD among the effective sites (except L3 in the healing group) (P> 0.05). Conclusion With the extension of time, 131I treatment of hyperthyroidism effectively improve the number of parts of the bone to improve.