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131I与抗甲状腺药物治疗甲亢性心脏病临床疗效比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第1期
页码:
120-122
栏目:
临床研究
出版日期:
2010-10-27

文章信息/Info

Title:
Efficacy comparison between 131I and anti-thyroid drugs for treatment of thyrotoxic cardiopathy
作者:
云辉吴国超
解放军第187中心医院门诊部,海南 海口 571159
Author(s):
YUN Hui WU Guo-chao
Out-patient Department, PLA 187 Hospital, Haikou 571159, Hainan, China
关键词:
心脏病甲状腺机能亢进性放射性同位素碘抗甲状腺药物
Keywords:
cardiopathy thyrotoxic 131I anti-thyroid drugs
分类号:
R581.1
DOI:
-
文献标识码:
A
摘要:
目的: 比较131I与抗甲状腺药物(ATD)治疗甲亢性心脏病的临床疗效。方法: 对226例甲亢性心脏病患者分别采用131I(151例)及ATD(75例)治疗,比较两组病例的临床疗效、治疗前后甲状腺激素水平、心电图及超声心动图变化情况。结果: 131I组的总有效率显著高于ATD组(P<0.01);且心功能改善及心电图好转率均显著高于ATD组(均P<0.01)。超声心动图检查:131I组患者LVEF、LVEDD、LVESD、SV及CO治疗后较治疗前显著改善(P<0.01);ATD组治疗前后差异无统计学意义;治疗后两组指标相比差异有统计学意义(P<0.01)。两组治疗后甲状腺激素水平较治疗前均显著降低(P<0.01),但两组治疗后甲状腺激素水平相比无统计学意义。131I组甲状腺功能减退(甲减)发生率显著高于ATD组(17% vs. 0%,P<0.01)。结论: 131I治疗甲亢性心脏病综合疗效优于ATD,缺点是甲减发生率高。
Abstract:
AIM: To compare the efficacy between 131I and anti-thyroid drugs (ATD) for treatment of thyrotoxic cardiopathy. METHODS: Two hundred and twenty-six patients with thyrotoxic cardiopathy were treated, respectively, with 131I (151 cases) and ATD (75 cases). Efficacy, changes of thyroid hormones, and results of electrocardiogram and echocardiogram were compared between groups. RESULTS: The total effective rate of 131I group was higher than the ATD group (P<0.01) and the improvement of cardiac function and electrocardiogram in 131I group was better than that in ATD group (P<0.01). Significant improvement was found in the levels of LVEF, LVEDD, LVESD, SV and CO before and after treatment in 131I group (P<0.01). No significant difference was observed in the results of echocardiogram before and after treatment in ATD group and no significant difference was seen in the results of echocardiogram between groups (P<0.01). Obvious descent was observed in the level of thyroid hormones after treatment compared with that before treatment in each group (P<0.01). But no significant difference was observed after treatment between groups. The incidence of hypothyroidism in 131I group was higher than that in ATD group (17% vs. 0%, P<0.01). CONCLUSION: 131I is more effective than ATD in the treatment of thyrotoxic cardiopathy but with a higher incidence of hypothyroidism.

参考文献/References

[1]梁华举,马玉琴,种冠峰,等. 131I治疗甲亢性心脏病108例临床分析[J]. 中国地方病防治杂志, 2008, 23(3):235-237.

[2]赵明,于景,宋华,等. 放射性131I治疗甲亢性心脏病的疗效评价[J]. 中国医师杂志, 2005, 7(9):1286-1287.

[3]韦智晓,覃伟武,李俊红,等. (131)碘治疗甲亢性心脏病的763例临床分析[J]. 广西医学院学报, 2008, 25(3):457-458.

[4]金毅. 131I治疗甲亢性心脏病[J]. 医学信息, 2006, 19(1):131-132.

备注/Memo

备注/Memo:
收稿日期:2010-02-23.作者简介:云辉,主治医师Email:lsb_2000@126.com
更新日期/Last Update: 2010-10-27