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[甲亢患者放射性碘治疗后选定氧化应激参数的评估]

[The evaluation of selected oxidative stress parameters in patients after radioiodine treatment of hyperthyroidism].

作者信息

Owczarek Tomasz, Kowalczyk Edward, Poliwczak Adam Rafał, Bała Agnieszka, Broncel Marlena

机构信息

Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland.

出版信息

Pol Merkur Lekarski. 2012 Jun;32(192):382-7.

Abstract

UNLABELLED

Oxidative stress is an important factor of the hyperthyroidism pathogenesis. The radioiodine therapy is an approved treatment method of this common disease and it is connected with exposure to ionizing radiation, which induces increased generation of reactive oxygen species in patient's organism. The aim of the study was to estimate the selected oxidative stress parameters in hyperthyroid patients, initially treated with thiamazole and subsequently with radioiodine. The evaluated parameters were the activity of superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GPx) in erythrocytes as well as the level of total antioxidative status (TAS) in plasma.

MATERIAL AND METHODS

In the study participated 29 healthy volunteers and 27 hyperthyroid patients, treated with thiamazole and prepared for radioiodine therapy. The antioxidant enzymes activity and the level of TAS were measured before administration of radioiodine therapeutic dose (average 18.47 +/- 8.81 mCi) as well as 30 days after treatment and achieving euthyreosis.

RESULTS

Hyperthyroid patients prepared with thiamazole for radioiodine therapy demonstrated higher GPx activity (p < 0.0001) and lower TAS level (p < 0.0001) than healthy people. Patients, who become euthyroid after 30 days from radioiodine therapy, were characterised by the increased activity of CAT (p < 0.05) and GPx (p < 0.05) as well as the higher level of TAS (p < 0.05). Patients after radioiodine treatment in comparison to the control group had the same activity of CAT and the level of TAS, although the activity of CuZn-SOD (p < 0.05) and GPx (p < 0.0001) occurred higher than in the control group. Moreover patients with hyperthyroidism before radioiodine treatment showed positive correlation between the level of TSH and TAS, whereas after radioiodine therapy they demonstrated positive correlation between the level of TSH and the activity of CuZn-SOD, CAT and GPx. However, there was no statistically significant correlation between the quantity of administrated radioiodine dose and the value of estimated oxidative stress parameters.

CONCLUSIONS

The results of the study show the occurrence of oxidative stress in hyperthyroid patients prepared with thiamazole to radioiodine therapy. Euthyreosis achieved by radioiodine treatment effected on normalisation of the activity of CAT and the level of TAS, although the activity of CuZn-SOD and GPx stayed increased. After the analysis of correlation between TSH level, radioiodine dose and measured parameters we can conclude that the intensity of oxidative stress more depends on current thyreometabolic state than on the therapeutic method applied.

摘要

未标注

氧化应激是甲状腺功能亢进症发病机制的一个重要因素。放射性碘治疗是这种常见疾病的一种认可的治疗方法,它与暴露于电离辐射有关,这会导致患者机体中活性氧的生成增加。本研究的目的是评估初用甲巯咪唑治疗随后接受放射性碘治疗的甲状腺功能亢进患者的选定氧化应激参数。评估的参数包括红细胞中超氧化物歧化酶(铜锌超氧化物歧化酶)、过氧化氢酶和谷胱甘肽过氧化物酶的活性以及血浆中总抗氧化状态水平。

材料与方法

29名健康志愿者和27名接受甲巯咪唑治疗并准备接受放射性碘治疗的甲状腺功能亢进患者参与了该研究。在给予放射性碘治疗剂量(平均18.47±8.81毫居里)之前以及治疗30天后达到甲状腺功能正常时,测量抗氧化酶活性和总抗氧化状态水平。

结果

用甲巯咪唑准备接受放射性碘治疗的甲状腺功能亢进患者的谷胱甘肽过氧化物酶活性较高(p<0.0001),总抗氧化状态水平较低(p<0.0001)。放射性碘治疗30天后甲状腺功能恢复正常的患者的特征是过氧化氢酶(p<0.05)和谷胱甘肽过氧化物酶(p<0.05)活性增加以及总抗氧化状态水平较高(p<0.05)。与对照组相比,放射性碘治疗后的患者过氧化氢酶活性和总抗氧化状态水平相同,尽管铜锌超氧化物歧化酶(p<0.05)和谷胱甘肽过氧化物酶(p<0.0001)活性高于对照组。此外,放射性碘治疗前的甲状腺功能亢进患者促甲状腺激素水平与总抗氧化状态呈正相关,而放射性碘治疗后他们促甲状腺激素水平与铜锌超氧化物歧化酶、过氧化氢酶和谷胱甘肽过氧化物酶活性呈正相关。然而,给予的放射性碘剂量与估计的氧化应激参数值之间没有统计学上的显著相关性。

结论

研究结果表明,用甲巯咪唑准备接受放射性碘治疗的甲状腺功能亢进患者存在氧化应激。放射性碘治疗实现的甲状腺功能正常化使过氧化氢酶活性和总抗氧化状态水平恢复正常,尽管铜锌超氧化物歧化酶和谷胱甘肽过氧化物酶活性仍升高。在分析促甲状腺激素水平、放射性碘剂量与测量参数之间相关性后,我们可以得出结论,氧化应激的强度更多地取决于当前的甲状腺代谢状态而非所应用的治疗方法。

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