摘要
目的：观察Graves病合并中度肝损害患者^131Ⅰ联合保肝药物治疗后肝功能指标的变化，探讨这类患者治疗的临床效果，同时根据患者肝功能指标变化确定保肝药物的停药时机。方法：符合本研究范围的67例患者应用^131Ⅰ联合保肝药物治疗。根据患者肝功能损害情况分为A组和B组，其中A组单纯ALT（丙氨酸转氨酶）和（或）AST （天冬氨酸转氨酶）升高者38例，B组伴有TBIL（总胆红素）升高者29例。^131Ⅰ治疗后2周、1个月、3个月、6个月复查A组和B组的FT3、FT4、TSH、ALT、AST及TBIL 。结果：与治疗前相比，两组患者^131Ⅰ治疗后2个月、3个月及6个月，血清甲状腺激素水平与治疗前比较差异具有统计学意义。^131Ⅰ治疗1个月后两组患者ALT、AST与治疗前比较差异具有统计学意义。^131Ⅰ治疗3个月后TBIL与治疗前比较差异具有统计学意义。A组患者^131Ⅰ治疗后2月与1月肝功能指标相比较，差异有统计学意义，而^131Ⅰ治疗后3个月与2个月肝功能指标相比较，差异无统计学意义。B组患者^131Ⅰ治疗后3个月患者肝功能指标与2个月相比较差异有统计学意义；而^131Ⅰ治疗后3个月患者肝功能指标与6个月相比较，差异无统计学意义。67例患者中Graves病的治愈率为89.6%（60/67例）；肝损害的治愈率为95.5%（64/67例）。结论：Graves病合并中度肝损害患者^131Ⅰ联合保肝药物治疗是安全有效的，单纯以ALT和（或） AST升高的患者保肝药物治疗以2个月为宜，合并TBIL升高患者保肝药物治疗以3个月以上6个月以内为宜。
Objective：To explore the effectiveness of the patients with Grave＇s disease and moderate hepatic dysfunction received ^131Ⅰ and liver protectant therapy.and the time to withdrawl liver protectant.Methods：The study included 67 hyperthyroidism patients complicated with moderate hepatic dysfunction. These patients were divided into two groups, only ALT and （or） AST increased as A group （38 cases）, ALT and （or） AST associated with TBIL increased as B group （29 cases）.The changes of serum level of thyroid （FT3,FT4,TSH） and liver function （ALT,AST,TBIL） were observed in the 2 week,1,3,6 month after ^131Ⅰ therapy.Results：Compared with pretreatment,In the 2 months, 3 months and 6 months after ^131Ⅰ treatment, there were significant differences in serum thyroid hormone levels of two groups patients , there were significant differences in ALT and AST of two two groups patients in the 1 months、2 months, 3 months and 6 months after ^131Ⅰ treatment.The serum level of liver function in A group is statistical significance between the 2 month and the 1month after ^131Ⅰ treatment. But there is no statistical significance between the 2 month and the3month . The serum level of liver function in B group is statistical significance between the 3 month and the 2month after ^131Ⅰ treatment. But there is no statistical significance between the 3month and the 6month . The cure rate of Grave′s disease and hepatic dysfunction were 89.6% （60/67） and 95.5% （64/67）, separately.Conclusions：The treatment of ^131Ⅰ in Grave′s disease complicated with moderate hepatic dysfunction is safe and effective. The time to withdraw liver protectant is 2 months for the patients only with increased ALT and （or） AST. The time to withdrawl liver protectant is above 3months but Less than 6 months for the patients with increased TBIL,ALT and （or） AST.
出处
《医学检验与临床》
2014年第3期17-19,共3页
Medical Laboratory Science and Clinics
