^131I和抗甲状腺药物治疗糖尿病合并甲状腺机能亢进症临床观察

目的：评价^131I治疗糖尿病合并甲状腺机能亢进症的临床疗效。方法：57例糖尿病合并甲状腺机能亢进症患者分为^131I治疗组（27例）和抗甲状腺药物对照组（30例），于治疗后观察1～3年，比较2组的疗效、胰岛素的使用、甲状腺机能亢进症复发率、甲状腺功能减退症发生率及治疗的不良反应。结果：治疗组治疗后的总有效率81．5％，明显高于对照组（53．3％），差异有统计学意义（x^2=7．1，P〈0．01）；2例患者原使用胰岛素后改为口服降糖药（2／8，25％）。对照组甲状腺机能亢进症复发率（56．7％）和不良反应发生率（26．7％）明显高于治疗组（7．1％，0％），2组差异有统计学意义（x^2=9．04，P〈0．01，x^2=10．37，P〈0．01）。结论：^131I治疗糖尿病合并甲状腺机能亢进症优于抗甲状腺药物，疗效好、不良反应少。

Comparative study on ^131I and antithyroid drugs to the treatment of hyperthyroidism combined with diabetes mellitus

Objective To evaluate the therapeutic effect of ^131I on hyperthyroidism combined with diabetes mellitus. Methods Fifty-seven patients with hyperthyroidism and diabetes mellitus were divided into ^131I group （27 cases） and antithyroid drugs group （30 cases）. The therapeutic effect, the use of insulin, recurrence rate of hyperthyroidism, incidence rate of hypothyroidism and the adverse reactions were observed and compared from 1 to 3 years after treatment. Results The total effective rate of ^131I group （81.5%） was higher than that of antithyroid drugs group （53.3%） （x^2=7.1, P〈 0.01）. After treatment, 25 %（2/8） patients in the ^131I group changed to take oral antidiabetie drug. The recurrence rate of hyperthyroidism and the incidence rate of adverse reactions in the antithyroid drugs group were 56.7% and 26.7% respectively, higher than those in the ^131I group （7.1% and 0, respectively） （ x^2=9. 04, P〈0. 01,x^2=10. 37, P〈0. 01 ）. Conclusion ^131I therapy, with better therapeutic effect and less adverse reactions, is preferred in the treatment of hyperthyroidism combined with diabetes to antithyroid drugs.