放射性碘治疗非巨大结节性甲状腺肿所致老年亚临床甲状腺功能亢进及其对骨代谢的影响
Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism.
作者信息
Rosario Pedro Weslley
机构信息
Instituto de Ensino e Pesquisa, Santa Casa de Belo Horizonte, Rua Domingos Vieira, 590, 30150-240 Belo Horizonte, MG, Brazil.
出版信息
Arq Bras Endocrinol Metabol. 2013 Mar;57(2):144-7. doi: 10.1590/s0004-27302013000200008.
OBJECTIVE
To evaluate 131I therapy in elderly patients with subclinical hyperthyroidism (SCH) due to nodular disease and who did not receive antithyroid drugs (ATDs), and the effect of the treatment on bone metabolism.
SUBJECTS AND METHODS
Thirty-six patients with TSH ≤ 0.1 mIU/L and non-voluminous goiter (< 60 cm³) were studied. Bone mineral density (BMD) was assessed in 17 women with osteopenia.
RESULTS
Mean 24-h 131I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5%) patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3%) patients, and hypothyroidism was detected in one (2.7%). In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average.
CONCLUSIONS
In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia.
目的
评估¹³¹I治疗因结节性疾病导致的老年亚临床甲状腺功能亢进症（SCH）且未接受抗甲状腺药物（ATD）治疗患者的疗效，以及该治疗对骨代谢的影响。
对象与方法
研究36例促甲状腺激素（TSH）≤0.1 mIU/L且甲状腺肿不大（<60 cm³）的患者。对17例骨质疏松的女性进行骨密度（BMD）评估。
结果
平均24小时¹³¹I摄取率为17.5%。治疗后第一周，有2例（5.5%）患者出现甲状腺毒症症状。放射性碘治疗一年后，30例（83.3%）患者的SCH得到缓解，1例（2.7%）患者出现甲状腺功能减退。在TSH恢复正常的患者中，股骨和腰椎骨密度平均分别增加了1.9%和1.6%。
结论
在患有SCH且甲状腺肿不大的老年患者中，未使用ATD先行治疗的放射性碘治疗是一种安全有效的治疗选择。SCH的缓解对绝经后骨质疏松女性的骨密度有有益影响。
Zotero 插件