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背景甲状腺功能亢进合并肝损害是一种常见病,治疗很棘手,尤其是甲状腺象合并严重肝损害。已经证实丙基硫尿嘧啶和甲巯基嘧唑可致肝损害甚至肝衰竭或爆发性肝炎而死亡。如果以丙基硫尿嘧啶和甲巯基嘧唑控制甲状腺功能亢进,肝功能将更加恶化甚至患者死亡;如果只进行保肝治疗,甲状腺功能亢进无法控制,患者同样会恶化而死亡。目的以131I控制甲状腺危象合并肝损害患者的甲状腺危象,同时进行内科保肝治疗,从而患者逐渐康复。方法一次性口服131I,具体剂量由核医学专科医生根具体情况而定。结果一甲状腺危象合并严重肝损害患者(60岁老年男性患者)一次性口服6mCi131I,甲状腺危象得到控制,肝脏功能逐渐恢复。结论131I治疗甲状腺危象合并严重肝损害这一方法更安全、更有效、更方便、更具有可行性,值得临床广泛运用。
Background Hyperthyroidism with liver damage is a common disease, treatment is very difficult, especially the thyroid gland with severe liver damage. Propylthiouracil and methimazole have been shown to cause liver damage or even hepatic failure or fulminant hepatitis. If propylthiouracil and methylmercaptopurine control of hyperthyroidism, liver function will be even worsened and even the patient died; if only liver protection, hyperthyroidism can not be controlled, the same patients will deteriorate and died. Objective 131I control of thyroid crisis with thyroid crisis in patients with thyroid crisis, while medical treatment of liver, so that patients gradually recovered. Methods One-time oral 131I, the specific dose by the nuclear medicine specialist root specific circumstances. Results In a thyroid crisis with severe liver damage (60-year-old male patient), oral administration of 6mCi131I, thyroid crisis was controlled, liver function gradually restored. Conclusion 131I treatment of thyroid crisis with severe liver damage this method is safer, more effective, more convenient and more feasible, it is widely used in clinical.