Graves病131I治疗前后Ghrelin及胰岛素样生长因子―1变化及临床意义.docVIP

Graves病131I治疗前后Ghrelin及胰岛素样生长因子―1变化及临床意义 　　[摘要]目的 探讨不同剂量131I治疗Graves病前后Ghrelin及胰岛素样生长因子-1（IGF-1）的变化及临床意义。方法 选取2013年1～12月收治的54例Graves病患者及同期的40例健康体检者作为研究对象。将Graves病患者分为小剂量组、大剂量组，各27例，健康体检者作为对照组。小剂量组口服131I溶液2.60～2.95 MBq/g甲状腺组织，大剂量组给予口服131I溶液3.69～4.41 MBq/g甲状腺组织。比较各组治疗前后的Ghrelin、IGF-1水平及血清FT3、FT4、TSH含量，记录两组的甲状腺功能减退发生率及甲状腺功能亢进复发率。结果 小剂量组、大剂量组治疗前的IGF-1、FT3、FT4水平显著高于对照组，TSH、Ghrelin水平低于对照组，差异有统计学意义（P0.05）。小剂量组的复发率低于大剂量组，差异有统计学意义（P0.05）。结论 小剂量131I治疗Graves病的临床疗效确切，复发率低，值得推荐。 　　[关键词]131I；Graves病；Ghrelin；胰岛素样生长因子-1 　　[中图分类号] R581.3 [文献标识码] A [文章编号] 1674-4721（2016）07（b）-0060-03 　　[Abstract]Objective To explore the change and clinical significance of Ghrelin and insulin like growth factor-1 （IGF-1） in patients with Graves disease before and after treatment with different doses of 131I.Methods 54 cases patients with Graves disease and 40 cases of healthy physical examination from January 2013 to December were selected.The patients with Graves disease were divided into the low dose group and the high dose group，27 cases in each group.The healthy persons were selected as the control group.The patients in the low dose group were treated with 131I of 2.60-2.95 MBq/g，while the patients in the high dose group were given 131I of 3.69-4.41 MBq/g treatment.The serum Ghrelin and IGF-1 level and serum FT3，FT4，TSH content before and after treatment in the two groups was compared.The incidence rate of hypothyroidism and recurrence rate in the two groups was recorded.Results The level of FT3，FT4，IGF-1before treatment in the low dose group and the high dose group was higher than that in the control group，the level of TSH，Ghrelin before treatment in the low dose group and the high dose group was lower than that in the control group，with significant difference （P0.05）.The recurrence rate in the low dose group was lower than that in the higher dose group，with significant difference （P 　　[Key words]131I；Graves disease；Ghrelin；Insulin like growth factor-1 　　Graves病是内分泌科常见的疾病之一，表现为神经精神症状、突眼和高代