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目的评价131Ⅰ治疗甲状腺功能亢进症(甲亢)合并糖代谢异常的疗效及安全性。方法 108例甲亢合并糖代谢异常患者分为131Ⅰ治疗组55例和抗甲状腺药物(ATD)对照组53例,比较两组甲亢的疗效、血糖、糖化血红蛋白(HbA1c)、胰岛β细胞功能及不良反应。结果治疗组甲亢总有效率显著高于对照组(P=0.008),复发率显著低于对照组(P=0.001),甲状腺功能减退症(甲减)发生率高于对照组(P=0.031),治疗后治疗组的空腹血糖(FPG)、餐后2 h血糖(2hPG)、HbA1c及胰岛素抵抗指数显著低于对照组(P<0.05),胰岛素分泌指数显著高于对照组(P<0.05)。治疗组无其他不良反应,对照组出现糖尿病酮症酸中毒、低血糖等不良反应。结论 131I治疗甲亢合并糖代谢异常疗效好,不良反应少。
Objective To evaluate the efficacy and safety of 131 Ⅰ in the treatment of hyperthyroidism (hyperthyroidism) complicated with abnormal glucose metabolism. Methods A total of 108 hyperthyroidism patients with abnormal glucose metabolism were divided into 131 Ⅰ treatment group and 53 antithyroid drugs (ATD) control group. The curative effect, blood glucose, glycosylated hemoglobin (HbA1c), pancreatic β-cell function and adverse reactions . Results The total effective rate of hyperthyroidism in the treatment group was significantly higher than that of the control group (P = 0.008), the recurrence rate was significantly lower than that of the control group (P = 0.001), and the incidence of hypothyroidism was lower than that of the control group (P = 0.031) After treatment, fasting blood glucose (FPG), postprandial 2h blood glucose (2hPG), HbA1c and insulin resistance index of the treatment group were significantly lower than those of the control group (P <0.05), insulin secretion index was significantly higher than that of the control group (P <0.05) . No adverse reactions in the treatment group, the control group, diabetic ketoacidosis, hypoglycemia and other adverse reactions. Conclusion 131I treatment of hyperthyroidism complicated with abnormal glucose metabolism, adverse reactions.