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碳酸锂联合131I治疗graves病合并白细胞减少症的效果分析

文晓琴1,欧阳良2,3,胡健康2,3,卢潇潇3,4,朱静茹3,5,高海波3,5   

  1. 1. 江西省萍乡市人民医院
    2. 江西省萍乡市人民医院核医学科
    3.
    4. 江西省萍乡市人民医院药剂科
    5. 江西省萍乡市人民医院甲状腺科
  • 收稿日期:2013-11-08 修回日期:2014-04-28 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 文晓琴

Clinical Study of Lithium Carbonate Combined with 131I for Treatment of Graves’Disease with Leucocytopenia

  • Received:2013-11-08 Revised:2014-04-28 Published:2014-08-15 Online:2014-08-15

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摘要：

【摘要】目的  探讨碳酸锂联合131I治疗Graves病合并白细胞减少症的疗效和临床价值。方法  将348例
Graves病合并白细胞减少症患者随机分成试验组和对照组，试验组178例，采用碳酸锂联合131I治疗；对照组170例，仅用131I治疗。分析各组治愈率、有效率，24h甲状腺摄131I率，游离三碘甲状腺原氨酸（FT3）、血清游离甲状腺素（FT4）水平以及外周血白细胞水平。结果  试验组治愈率高于对照（87.6%vs71.8%），2组有效率差异无统计学意义（97.8%vs94.1%）。碳酸锂治疗1周后试验组24h摄131
I率高于对照组[ （69.75±6.79）%vs（44.27±3.27）%]。治疗后2周，1个月，试验组治疗后各时点FT3及FT4水平均显著降低。而对照组在治疗后2周，FT3及FT4水平较治疗前升高，治疗后1个月后，FT3及FT4水平开始降低。试验组治疗后3个月，外周血白细胞数量即高于治疗前（4.82±0.76vs3.26±0.63，P＜0.01）。结论  碳酸锂联合131I治疗Graves病合并白细胞减少症安全、有效。

关键词: Graves病, 白细胞减少, 碳酸锂, 碘, 三碘甲状腺原氨酸, 甲状腺素

Abstract: [Abstract] Objective   To explore the efficacy and clinical value of the 131I combined with lithium carbonate in the treatment of Graves’ disease with leucocytopenia. Methods   348 patients were randomly divided into two groups.178 patients of the experimental group were treated with131I plus lithium carbonate; 170 patients of the control group were only treated with 131I .The data of recovery rate, effective rate, thyroid 131I uptake rate, the level of thyroid hormone (free triiodothyronine, FT3 and free thyroxine , FT4）and peripheral blood leukocyte were analyzed retrospectively. Results   The recovery rate of the experimental group（87.6%） is significantly higher than the control group（71.8%）. But the effective rate of the experimental group（97.8%） is not significantly higher than the control group（94.1%）.The rate of 131I uptake 24h in the experimental group （69.75±6.79）are higher than that in the control group （44.27±3.27）after the treatment of lithium carbonate .The level of thyroid hormone(FT3, FT4) in the experimental group are significantly lower than that before treatment after 2 weeks, 1 months. However, the level of thyroid hormone (FT3, FT4) in the control group are higher than that before treatment after 2 weeks and begin to decrease after 1 month. The treatment of experimental group contribute to improve the level of peripheral blood leukocyte faster. The level of peripheral blood leukocyte was significantly higher than that before treatment after 3 months （P＜0.01）.Conclusion   The treatment of lithium carbonate combined with 131I for Graves' disease with leukopenia is safe and effective.

Key words: Graves’ disease, Leukopenia, Lithium carbonate, iodine, triiodothyronine, thyroxine