【摘要】 目的了解甲状腺功能亢进症(甲亢)病人131I治疗前后骨质含量的变化。方法甲亢病人69例,131I治疗后3个月治愈24例,好转19例,甲状腺功能减退(甲减)14例,无效12例;治疗后6个月后治愈34例,好转10例,甲减18例,无效7例,治愈、好转及甲减为治疗有效者。应用双能X线骨密度仪,测定131I治疗前、治疗后3个月及6个月病人一侧股骨颈、ward’s三角、大转子和L2、L3、L4部位骨密度。以30例健康体检者作为对照组。结果治疗3、6个月治愈组ward’s三角、大转子、L2、L3、L4等5个部位治疗前骨密度均低于对照组,差异有显著性(t=2.635~4.479,P<0.05)。治疗3个月好转组ward’s三角、大转子、L3、L4等4个部位治疗前骨密度低于对照组,差异有显著性(t=2.156~4.390,P<0.05);治疗6个月好转组ward’s三角、大转子2个部位,甲减组ward’s三角、大转子、L2、L3、L4等5个部位治疗前骨密度低于对照组,差异有显著性(t=2.150~3.134,P<0.05)。治疗后6个月治疗有效组(包括治愈、好转和甲减组)各部位骨密度均高于治疗前,差异有显著性(t=2.579~12.008,P<0.05);与对照组比较,治疗有效组各部位(治愈组L3部位除外)骨密度差异无显著性(P>0.05)。结论随着时间的延长,甲亢131I治疗有效者骨质改善部位数逐渐增多。更多还原

【Abstract】 Objective To investigate the changes of bone mineral density(BMD)-before and after 131I therapy-in patients with hyperthyroidism. Methods Sixty-nine patients with hyperthyroidism were treated with 131I.After three months of treatment,24were cured,19improved,14had hypothyroidism,and 12no response;after six months,34were cured,10improved, 18had hypothyroidism,and seven failed.Cure,improvement,and hypothyroidism were regarded as effective.The BMD in femur neck,Ward’s triangle,greater trochanter of femur,L2,L3and L4were detected by dual-energy X-rays absorptiometry(DEXA), and 30healthy individuals were served as controls. Results Of patients in the cured group-after 3-6-month 131I therapy-the BMD of Ward’s triangle,greater trochanter of femur,L2,L3and L4before treatment was lower than that of the controls,the difference was significant(t=2.635-4.479,P<0.05);of those improved after three months of 131I therapy,BMD of the same parts as in the cured group before treatment was lower than that in the control(t=2.156-4.390,P<0.05).BMD of Ward’s triangle and greater trochanter of femur in the improved group,and that of Ward’s triangle and greater trochanter of femur,L2,L3and L4in the hypothyroidism group-six months after treatment-were lower than corresponding parts in control group before therapy(t=2.150-3.134,P<0.05).After six months of therapy,BMD in each part was higher than that before treatment in each response group-including cure,improved and hypothyroidism group(t=2.579-12.008,P<0.05).The differences among each effective group and the control were not significant in terms of BMD in each part-except L3in cured group(P>0.05). Conclusion Along with extension of time,the number of improved location of BMD will increase in patients with hyperthyroidism respond well to 131I therapy.更多还原