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目的了解甲亢经131I治疗后引发甲减的患者在行甲状腺素替代治疗前后甲状腺显像结果差异的分析。方法对28例甲亢行131I治疗后引发甲减的患者,在其行甲状腺素替代治疗前后进行两次显像,对两次显像的定量指标(T/B)及甲状腺重量进行对比及临床分析。结果28例甲减患者甲状腺素替代治疗前显像,甲状腺显影模糊9例(32%),显影清晰19例(68%);甲状腺素替代治疗后显像,甲状腺显影模糊21例(75%),显影清晰7例(25%)。替代治疗前甲状腺与唾液腺放射性比(T/B)明显较治疗后增高t=5.59,(P<0.01);替代治疗前甲状腺重量也较治疗后显著增加t=2.40,(P<0.01)。结论甲状腺显像对131I治疗后引发甲减患者的甲状腺功能评估具有肯定的临床意义,但当患者体内血清TSH水平较高时显像可能导致甲状腺功能评估错误,临床应需予注意。
Objective To investigate the difference of thyroid imaging before and after thyroxine replacement therapy in patients with hyperthyroidism induced by hypothyroidism after 131I treatment. Methods Twenty-eight patients with hypothyroidism who underwent hypothyroidism after 131I treatment were scored twice before and after thyroxine replacement therapy. The contrast and clinical analysis of quantitative indicators (T / B) and thyroid weight . Results A total of 28 cases of hypothyroidism were treated with thyroid hormone replacement therapy. Thyroid development was blurred in 9 cases (32%) and developed in 19 cases (68%). After thyroid hormone replacement therapy, 21 cases (75% , Clear imaging in 7 cases (25%). The ratio of thyroid to salivary gland before radiotherapy (T / B) was significantly higher than that after treatment (t = 5.59, P <0.01). Thyroid weight before treatment was also significantly increased by t = 2.40 (P <0.01). Conclusions Thyroid imaging has positive clinical value in the assessment of thyroid function in patients with hypothyroidism after 131I treatment. However, when the level of serum TSH is high in patients, imaging may lead to incorrect evaluation of thyroid function. Clinical should be noted.