Wilson R, McKillop J H, Black E, Jenkins C, Thomson J A
University Departments of Medicine, Royal Infirmary, Glasgow, UK.
Eur J Nucl Med. 1988;14(4):180-3. doi: 10.1007/BF00257324.
The aim of this study was twofold. Firstly to assess the post treatment predictive value of various biochemical and immunological tests for early hypothyroidism after 131I therapy for Graves' disease, and secondly to determine whether or not pretreatment with Carbimazole protects against post treatment hypothyroidism. The early changes observed in serum T3, T4, TSH, thyroid microsomal and thyroglobulin antibody levels were found to be of no predictive value. A sharp rise, around 2 months, in TRAb levels following 131I therapy indicated that hypothyroidism was likely to occur. This rise was thought to reflect a greater degree of thyroid damage. Lower levels of thyroglobulin in patients who had become hypothyroid by 12 months after treatment would support this view. Five weeks Carbimazole pretreatment in this relatively small group of patients did not appear to protect against hypothyroidism.
本研究有两个目的。其一,评估131I治疗Graves病后各种生化和免疫检测对早期甲状腺功能减退的治疗后预测价值;其二,确定甲巯咪唑预处理是否可预防治疗后甲状腺功能减退。血清T3、T4、TSH、甲状腺微粒体抗体和甲状腺球蛋白抗体水平的早期变化未发现有预测价值。131I治疗后约2个月TRAb水平急剧升高表明可能发生甲状腺功能减退。这种升高被认为反映了甲状腺损伤程度更大。治疗后12个月出现甲状腺功能减退的患者甲状腺球蛋白水平较低支持这一观点。在这一相对较小的患者组中进行五周的甲巯咪唑预处理似乎不能预防甲状腺功能减退。