【摘要】 目的:分析131I治疗甲状腺功能亢进(简称甲亢)后早发甲状腺功能减退(简称甲低)的临床特点和远期随访结果。方法:对150例131I治疗甲亢后1年内出现甲低的患者进行临床分析,并对其中120例进行门诊随访1～5年,平均3年。结果:(1)暂发性甲低组40例,占33.33%,其中1年内甲状腺功能恢复正常者28例,再发甲亢者12例。远期随访显示,甲状腺功能正常者有5例在1～4年后出现甲低;甲亢者中有6例在3个月～2年甲状腺功能恢复正常,4例在3个月～2年后出现永久性甲低。(2)永久性甲低组80例,占66.67%,其中95%(76例)在131I治疗后1～6个月出现甲低;有临床症状者占85%(68例);有用小剂量131I(≤185MBq)者占83.75%(67例)。结论:早发甲低中多为永久性甲低,后者中服用小剂量131I治疗者多;暂发性甲低的转归不能用于预测以后的甲状腺功能。更多还原

【Abstract】 Objective:To analyse the clinical features and long-term follow-up results of early-onset hypothyroidism ater 131I in treating hyperthyroidism.Methods:150 patients with hyperthyoidism who developed hypothyroidism within 12 months ater 131I therapy were analysed clinically by clinical symptoms and plasma T3,T4 and thyroid-stimulating hormone (TSH).120 of them were divided into two groups according to the occurrence of hypothyroidism after one yeay of treatment.Results:(1)There were 40 patients with transient hypothyroidism in the group 1,70%(28/40) of them returned to euthyroidism and 30%(12/40) of them developed hyperthyroidism again within 1 year after 131I treatment.The long-term folowup shooed that 5 patients with euthyroidism and 4 patientswith hyperthyroidism developed permanent hypothyroidism and 4 patients with hyperthyroidism developed permanent hypothyroidism after 3 months～3 years as well as 6 patients with hyperthyroidism returned to euthyroidism after 3 months～2 year.(2)There were 80 patients with permanent hypothyroidism in the group 2,83.75%(67/80) of them were treated with low dwse 131I,and 85%(68/80) of cases in this group were found with clinical hypothyroid symptom.Conclusions:Classically,early-onset hypothyroidism was permanent hypothyroidism.The incidence of permanent hypothyroidism in the patients treated with low dose 131I treatment did not predict the future thyrold function.更多还原