摘要
目的探讨放射性碘治疗对毒性弥漫性甲状腺肿患者甲状腺功能、骨代谢及免疫功能的影响。方法选择南阳市中心医院2021年1月至2024年5月接受放射性碘治疗的毒性弥漫性甲状腺肿患者80例。比较治疗前、治疗后3个月的甲状腺功能指标[包括游离三碘甲状腺原氨酸(FT_(3))、促甲状腺激素(TSH)及游离甲状腺素(FT_(4))]、甲状腺自身抗体[包括促甲状腺素受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TGAb)]、骨代谢指标[包括I型胶原交联C端肽(ICTP)、I型原胶原C端前肽(PICP)、骨钙素(OCN)、碱性磷酸酶(ALP)]、免疫指标(包括CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))、分子生物标志物[包括自分泌运动因子(AMF)和溶血磷脂酸(LPA)]、甲状腺肿程度(采用甲状腺肿评分评估)及生活质量(采用Spitzer生活质量指数评分评估)。结果治疗后,FT_(3)、FT_(4)、TRAb、TPOAb、TGAb、ICTP、PICP、OCN、ALP、AMF、LPA水平及CD4^(+)、CD4^(+)/CD8^(+)、甲状腺肿评分均降低,TSH水平、CD8^(+)及Spitzer生活质量指数评分均升高,差异均有统计学意义(P<0.05)。结论放射性碘治疗后甲状腺功能及骨代谢相关指标改善,并伴随免疫细胞亚群分布改变;生活质量提高,甲状腺肿评分下降。
Objective To investigate the effects of radioiodine therapy on thyroid function.bone metabolism.and immune function in patients with toxic diffuse goiter.Methods A total of 80 patients with toxic diffuse goiter who received radioiodine therapy at Nanyang Central Hospital from January 2021 to May 2024 were enrolled.Thyroid function indicators.including free triiodothyronine(FT_(3)).thyroid-stimulating hormone(TSH).and free thyroxine(FT_(4));thyroid autoantibodies.including thyrotropin receptor antibody(TRAb).thyroid peroxidase antibody(TPOAb).and anti-thyroglobulin antibody(TGAb);bone metabolism indicators.including type I collagen cross-linked C-terminal telopeptide(ICTP).procollagen type I C-terminal propeptide(PICP).osteocalcin(OCN).and alkaline phosphatase(ALP);immune indices.including CD4^(+).CD8^(+).and the CD4^(+)/CD8^(+)ratio;molecular biomarkers.including autocrine motility factor(AMF)and lysophosphatidic acid(LPA);goiter severity(assessed using a goiter score);and quality of life(assessed using the Spitzer Quality of Life Index)were compared between baseline and 3 months after treatment.Results After treatment.levels of FT3.FT4.TRAb.TPOAb.TGAb.ICTP.PICP.OCN.ALP.AMF.and LPA.as well as CD4^(+).the CD4^(+)/CD8^(+)ratio.and the goiter score.were decreased.while TSH levels.CD8^(+).and the Spitzer Quality of Life Index score were increased;all differences were statistically significant(P<0.05).Conclusion Radioiodine therapy improves thyroid function and bone metabolism–related indicators and is accompanied by changes in the distribution of immune cell subsets.Quality of life is improved.and the goiter score is reduced.
作者
王乐柯
付玉娟
赵璐
吴岳
闵曙光
蔚荣豪
WANG Leke;FU Yujuan;ZHAO Lu;WU Yue;MIN Shuguang;YU Ronghao(Department of Nuclear Medicine,Nanyang Central Hospital,Nanyang Henan,473009,China)
出处
《临床研究》
2026年第2期50-53,共4页
Clinical Research
