摘要
目的探讨小剂量131I治疗Graves甲亢合并2型糖尿病的临床疗效。方法选取2011年6月~2012年6月河南省疾病预防控制中心甲状腺病门诊收治的30例Graves甲亢合并2型糖尿病患者,采用小剂量131I分次给药,每次1.5~2.5 mci,3个月为1个疗程,直到甲亢症状、体征好转,甲状腺功能测定正常后停药。分别于治疗后3、6、9、12个月测定血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、空腹血糖、餐后2小时血糖。结果 30例患者中Graves甲亢治愈24例,治愈率80.0%;好转4例,好转率13.3%;2例出现一过性甲状腺功能减退症(甲减),发生率为6.7%;无无效病例。2型糖尿病有效20例,有效率66.7%;好转8例,好转率26.7%。未出现甲亢危象、粒细胞减少、糖尿病酮症酸中毒等严重不良反应。结论小剂量131I是治疗Graves甲亢合并2型糖尿病一种安全有效的方法。
Objective To evaluate the effects of small 131 I dose on the treatment of Graves’disease with type 2 diabetes mellitus. Methods The study was performed for a total of 30 cases with Graves hyperthyroidism with type 2 diabetes mellitus. All of them were recruited from Outpatient of Thyroid Disease, Henan Province Center for Disease Prevention and Control from June 2011 to June 2012. The dosage of 131 I was varied from 1.5 to 2.5 mci based on the patient’s symptom and signs. Patients took 131 I one time per three months until being cured. Serum concentrations of thyroid-stimulating hormone （TSH）, free thyroxine （FT 4）, free triiodothyronine （FT 3）, fasting plasma glucose and postprandial 2 h plasma glucose were measured at baseline and after 3, 6, 9 and 12 months of follow-up. Results After one year’s follow-up, 24 cases of Graves’disease were cured and the cure rate was 80.0%;4 cases were improved and the improvement rate was 13.3%;The incidence rate of hypothyroidism was 6.7%;No invalid cases were found. 20 （66.7%） cases of type 2 diabetic patients were effictive;8 （26.7%） cases were partially remitted. There weren’t any serious adverse reactions across the whole treatment process, such as thyroid crisis, neutropenia and diabetic ketoacidosis. Conclusion The small dosage of 131 I may well be considered as an effective and safe method for treating Graves’disease with diabetes mellitus.
出处
《当代医学》
2014年第32期7-9,共3页
Contemporary Medicine
