Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Chongqing Key Laboratory of Ultrasound Molecular Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Endocrinol (Lausanne). 2022 Oct 18;13:1034374. doi: 10.3389/fendo.2022.1034374. eCollection 2022.
Treatment decision-making in Graves' disease (GD) with severe liver dysfunction (LD) is a clinical challenge. This research was carried out to evaluate the effect of radioiodine (I) with or without an artificial liver support system (ALSS) in GD patients with severe LD.
In total, 45 patients diagnosed with GD and severe LD were enrolled and allocated to two groups: patients treated with I alone (n=30) (Group A)and patients by a combination of I and ALSS (n=15)(Group B). Liver function, thyroid hormone concentrations, therapeutic efficacy, and the cost of treatment were compared between the two groups.
Thyroid hormone concentrations were lower 2 weeks after I treatment, but no deterioration in liver function was identified. There was no statistically significant difference in the treatment efficacy between the two groups. The hospital stay, total cost, and daily cost were lower in patients treated with I alone than in those treated with I and an ALSS (<0.05).
The key point of treating GD patients with severe LD is to control the GD.I is recommended as an effective and safe and should be applied as soon as possible once the diagnosis is clarified; however, when used in combination with an ALSS, there was no substantial improvement in therapeutic efficacy.
Graves 病(GD)合并严重肝功能不全(LD)的治疗决策是一个临床挑战。本研究旨在评估放射性碘(I)联合或不联合人工肝支持系统(ALSS)治疗 GD 合并严重 LD 患者的效果。
共纳入 45 例 GD 合并严重 LD 患者,分为两组:单独使用 I 治疗的患者(n=30)(A 组)和 I 联合 ALSS 治疗的患者(n=15)(B 组)。比较两组患者的肝功能、甲状腺激素浓度、治疗效果和治疗费用。
I 治疗后 2 周甲状腺激素浓度降低,但肝功能无恶化。两组治疗效果无统计学差异。单独使用 I 治疗的患者住院时间、总费用和日费用均低于 I 联合 ALSS 治疗的患者(P<0.05)。
治疗 GD 合并严重 LD 患者的关键是控制 GD。一旦明确诊断,建议使用 I 作为有效且安全的治疗方法,并尽快应用;但与 ALSS 联合使用时,治疗效果并无显著改善。