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目的对自身免疫性甲亢病人进行131I治疗并进行随访,以探讨治疗后不同时期患者血清中TPO-Ab水平变化。方法 184例患者131I治疗后进行随访,并选择我院健康体检者为对照,观察治疗后1、3、6及12个月疗效和血清FT3、FT4、sTSH及TPO-Ab变化情况。结果随着131I治疗后时间延长,甲功正常者逐渐增多,治疗12个月后,甲功正常者101例(55.19%),甲减50例(27.62%),未治愈32例(17.49%),总治疗有效率82.51%,与治疗1、3、6个月有明显区别(χ2=9.158,P=0.000);治疗后FT3水平逐渐下降,但直到治疗12个月后,184例患者FT3平均水平仍高于正常对照,差异有统计学意义(P<0.05);FT4水平逐渐下降,在治疗3个月时仍高于对照(P<0.05),但在治疗6个月时与对照相比差异无统计学意义(P>0.05);治疗后sTSH水平逐渐升高,在治疗12个月后与正常对照差异无统计学意义(P>0.05);治疗1个月后TOP-Ab水平仍较高,且与其他时间段差异有统计学意义(P<0.05),治疗3个月、6个月和12个月TOP-Ab水平仍高于正常对照,但互相之间差异无统计学意义(P>0.05)。结论 131I治疗后FT4水平恢复较快,sTSH次之,FT3改善最慢,血清TPO-Ab水平有变化但变化不明显。
Objective To investigate the changes of serum TPO-Ab levels in patients with autoimmune hyperthyroidism after 131I treatment and follow-up. Methods A total of 184 patients were followed up after 131I treatment. The healthy volunteers in our hospital were selected as the control group. The curative effect and the changes of serum FT3, FT4, sTSH and TPO-Ab were observed at 1, 3, 6 and 12 months after treatment. Results After 131I treatment, the normal thyroid function gradually increased. After 12 months of treatment, 101 cases (55.19%) had normal thyroid function, 50 cases (27.62%) had hypothyroidism, 32 cases (17.49%) had not cured, (Χ2 = 9.158, P = 0.000). After treatment, the level of FT3 decreased gradually. However, until the 12-month treatment, the mean of FT3 in 184 patients was significantly lower than that in the control group (P <0.05). The level of FT4 decreased gradually and was still higher than the control at 3 months (P <0.05), but at 6 months, the level of FT4 was lower than that of the control There was no significant difference between the two groups (P> 0.05). After treatment, the level of sTSH gradually increased and there was no significant difference between the two groups after 12 months of treatment (P> 0.05). After 1 month of treatment, the level of TOP-Ab still remained (P <0.05). The levels of TOP-Ab in the three months, six months and twelve months after treatment were still higher than those in the normal controls, but there was no significant difference between them P> 0.05). Conclusion The level of FT4 recovered faster after 131I treatment, followed by sTSH, the slowest improvement of FT3, and the change of serum TPO-Ab level but with no obvious change.