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目的:探讨TRAb、TGA、TMA在G raves’病131I治疗中的价值,了解131I治疗后早发性甲减产生的机理。方法:对167例G raves’病131I治疗患者进行治疗前及治疗后6个月检测TRAb、TGA、TMA和甲状腺功能,依据治疗后甲状腺功能状况分为甲亢未控制组91例、甲亢控制组48例和早发性甲减组28例,并对这三组治疗前后进行比较。结果:早发性甲减组年龄低于甲亢未控制组(P<0.01)。TRAb治疗前甲亢未控制组高于甲亢控制组和早发性甲减组(P<0.05)。各组治疗前后比较:治疗后甲亢未控制组与甲亢控制组的TRAb均高于治疗前(P<0.05),早发性甲减组的TGA、TMA治疗后高于治疗前(P<0.01)。TGA、TMA治疗后早发性甲减组明显高于甲亢未控制组和甲亢控制组(P<0.01)。结论:①G raves’病患者进行131I治疗时,年龄轻的比年龄大的容易发生早发性甲减;②131I治疗前血清中TRAb水平高的不易治愈,反之,要警惕早发性甲减。③Graves’病患者131I治疗后早发性甲减的发生可能与TGA、TMA阳性率增高有关。
Objective: To investigate the value of TRAb, TGA and TMA in the treatment of G raves’ disease 131I and to understand the mechanism of premature hypothyroidism after 131I treatment. Methods: 167 cases of 131 I patients with G ’s disease were treated with 131 I before treatment and 6 months after treatment. TRAb, TGA, TMA and thyroid function were detected. Thyroid function status was divided into 91 cases of hyperthyroidism uncontrolled group, 48 cases of hyperthyroidism control group Cases and early onset hypothyroidism in 28 cases, and these three groups before and after treatment were compared. Results: The age of patients with early-onset hypothyroidism was lower than that of patients without hyperthyroidism (P <0.01). TRAb before treatment in hyperthyroidism uncontrolled hyperthyroidism control group and early hypothyroidism group (P <0.05). The levels of TRAb in hyperthyroidism control group and hyperthyroidism control group were higher than those before treatment (P <0.05), TGA and TMA in the early onset hypothyroidism group were higher than those before treatment (P <0.01) . TGA, TMA treatment of early onset hypothyroidism was significantly higher than hyperthyroidism and hyperthyroidism control group hyperthyroidism control group (P <0.01). Conclusions: ①Graves’ disease in patients with 131I treatment, the younger than the age prone to early onset hypothyroidism; ②131I serum TRAb levels before treatment is not easy to cure, on the contrary, to be alert to early hypothyroidism. The incidence of early hypothyroidism after 131I treatment in patients with Graves’ disease may be related to the increased positive rate of TGA and TMA.