目的 研究放射性 ¹³¹I 在甲亢伴甲状腺结节中的应用价值。方法 纳入我院90例甲亢患者,根据其是否伴甲状腺结节分为无结节组(51例)、结节组(39例),均接受放射性 ¹³¹I 治疗。比较两组治疗总有效率,分析两组治疗前后血清甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)及游离甲状腺素(FT4)水平。结果 无结节组治疗总有效率74.51%,结节组为58.97%,差异无统计学意义(P＞0.05);两组治疗后TSH均高于治疗前(P＜0.05),FT3、FT4均低于治疗前(P＜0.05),TPOAb、TGAb较治疗前比较差异均无统计学意义(P＞0.05);无结节组治疗后FT3、FT4低于结节组(P<0.05),TPOAb、TGAb、TSH较结节组比较差异均无统计学意义(P＞0.05)。结论 放射性 ¹³¹I 治疗甲亢伴甲状腺结节效果好,且操作简单,副作用少,值得临床推广使用。

Objective To study the value of radioactivity ¹³¹I in hyperthyroidism with thyroid nodules. Methods Ninety patients with hyperthyroidism in our hospital were divided into non-nodule group (51 cases) and nodule group (39 cases) according to whether they had thyroid nodules or not. All patients received ¹³¹I radiation therapy. The total effective rate was compared between the two groups. The serum levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were analyzed before and after treatment. Results The total effective rate was 74.51% in non-nodule group and 58.97% in nodule group, with no significant difference (P>0.05);after treatment, TSH was higher in both groups than that before treatment (P<0.05), FT3 and FT4 were lower than that before treatment (P<0.05), TPOAb and TGAb had no significant difference compared with that before treatment (P>0.05);FT3 and FT4 in nodule-free group were lower than those in nodule group (P<0.05). TPOAb, TGAb and TSH had no significant difference compared with nodule group (P>0.05). Conclusion Radioactive ¹³¹I treatment of hyperthyroidism with thyroid nodules has good effect, simple operation and few side effects, which is worthy of clinical application.

目的 探讨妊娠期甲亢患者血清甲状腺功能和免疫含量变化及其临床应用价值。方法 分别取妊娠期与非妊娠期甲亢病例各250例,于孕15周、孕25周以及孕35周时测定两组血清甲状腺功能各项指标与免疫含量。结果 与对照组相比,观察组患者整个妊娠期T3、T4水平明显更高(P＜0.05);孕中晚期两组FT3、FT4水平差异并无统计学意义(P＞0.05)。结论 血清T3、T4在妊娠合并甲亢患者整个妊娠过程中呈高水平表达,临床应高度重视TRAb阳性率、FT3、FT4表达水平,以明确诊断。