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目的探讨131Ⅰ联合小剂量泼尼松治疗甲状腺功能亢进症Graves病(简称甲亢)的疗效及甲状腺功能减退(甲减)的发生率,突眼的变化。方法随机将58例甲亢患者,分对照组30例,采用一次性口服131Ⅰ治疗,平均剂量为200.5mbq(167.6-256.4mbq),观察6个月甲亢未愈者给予第2次治疗。治疗组28例,采用131Ⅰ联合小剂量泼尼松口服,在131Ⅰ治疗后第5天加服泼尼松30mg/d,连用4周,逐渐减量至5mg/d,维持2～3个月。结果观察两组治疗1年后的各项指标:疗效,甲状腺体积的改变,甲减发生率,两组比较差异无统计学意义(P>0.05)。突眼改变,治疗组突眼缓解率89%,对照组突眼缓解率47%,两组比较差异有统计学意义(P<0.01)。结论 131Ⅰ联合小剂量泼尼松治疗甲亢性突眼疗效满意。
Objective To investigate the therapeutic effect of 131 Ⅰ combined with low dose prednisone on Graves’ disease (Hyperthyroidism) and the incidence of hypothyroidism (hypothyroidism) and exophthalmos. Methods A total of 58 patients with hyperthyroidism were randomly divided into control group (n = 30) and oral 131I (n = 131). The mean dose was 200.5mbq (167.6-256.4mbq). In the treatment group, 28 cases were treated with 131 I combined with low-dose prednisone. Prednisone 30 mg / d was added on the 5th day after the 131 I treatment, and the dosage was reduced to 5 mg / d for 4 weeks for 2 to 3 months. Results After treatment for 1 year, the indexes of curative effect, the change of thyroid volume and the incidence of hypothyroidism were observed. There was no significant difference between the two groups (P> 0.05). Exophthalmos changed, the treatment group exophthalmos remission rate of 89%, 47% of the control group exophthalmos, the difference between the two groups was statistically significant (P <0.01). Conclusion 131 Ⅰ combined with low-dose prednisone treatment of hyperthyroidism exophthalmos effect is satisfactory.