大剂量131I治疗对分化型甲状腺癌患者肝功能的影响

目的:观察大剂量放射性131I对分化型甲状腺癌(DTC)患者肝功能的影响。方法:对经甲状腺次全切术后并经过病理确诊为DTC的31例患者［男6例，女25例，平均年龄（35±12.44）岁］，给予大剂量放射性131I［（4.66±0.72） GBq］治疗，统计分析患者治疗前、治疗后1个月、治疗后3个月肝功能的谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）等指标。结果:收集31例接受大剂量131I治疗的DTC患者，治疗前肝功能指标ALT、AST、TBIL均在正常范围以内；治疗后1个月，ALT、AST、TBIL检测结果显示异常的分别为3例（9.7%）、2例（6.5%）和0例；治疗后3个月，ALT、AST、TBIL检测结果显示异常的分别为1例（3.2%）、2例（6.5%）和0例。ALT及AST各项指标比较分析中， t检验的P＞0.05，差异均无统计学意义。治疗后1个月TBIL与3个月TBIL的t检验中，P＜0.05，即TBIL均数治疗后3个月稍降低，差异有统计学意义，但总体在正常值以内，且无一例出现异常结果。结论:大剂量放射性131I治疗DTC并不会在治疗后1个月及3个月造成明显肝功能损害。

The effect of high-dose 131I solution on hepatic function in patients with differentiated thyroid carcinoma

Objective:To observe the effect of high-dose 131I solution on hepatic function in patients with differentiated thyroid carcinoma.Methods:A total of 31 patients［6 male cases,25 female cases，average age （35±12.44) years old］ who received thyroid subtotal resection and pathologically diagnosed as differentiated thyroid carcinoma were recruited in this study.High-dose 131I solutions［(4.66±0.72) GBq］ were provided for the subjects in the treatment.Results of hepaticfunction indexes,such as ALT,AST,TBIL,were collected（before treatment,one month after treatment and three months after treatment) and analyzed statistically.Results:Hepatic function indexes（ALT,AST and TBIL) were within the normal range in 31 DTC subjects before receiving high-dose 131I treatment.One month after treatment,subjects with abnormal hepatic function index changes were 3 cases（9.7%),2 cases（6.5%) and 0 case,for ALT,AST and TBIL respectively.Three months after treatment,subjects with abnormal hepatic function index changes were 1 case（3.2%),2 cases（6.5%) and 0 case,for ALT,AST and TBIL respectively.No statistical significance was observed in hepatic function indexes of ALT and AST（P＞0.05).Though the TBIL results after the treatment were all within the normal range with no exceptions,average TBIL results of one month after treatment were slightly lower than that of three months after treatment,which the difference was statistically significant（P＜0.05).Conclusion:The application of high-dose 131I in DTC treatment had no obvious detrimental effect on hepatic function one month or three months after receiving the treatment.