碳酸锂联合131I治疗Graves病的研究

目的观察碳酸锂对Graves病^131I治疗后血清甲状腺激素水平的影响。方法将30例拟行^131I治疗的Graves病患者随机分为单独使用^131I治疗组(^131I组)和^131I 碳酸锂组。服^131I的同日开始服用碳酸锂，0．25g，3次，d，共6d。均于^131I治疗前和治疗后7，14和30d分别检查血清FT3、FT4和TSH。使用单因素方差分析各组组内和组间差别。结果^131I组治疗后7d血清FT3和FT4水平高于治疗前，以后逐渐下降，TSH于^131I治疗后14d逐渐上升，甲状腺体积逐渐减小。^131I 碳酸锂组^131I治疗后血清FT3和FT4水平均低于^131I治疗前，并逐渐下降，TSH逐渐上升，甲状腺体积减小。结论碳酸锂可降低Graves病^131I治疗后血清甲状腺激素水平。

Comparative study of 131 I with 131 I plus lithium carbonate in the treatment of Graves' hyperthyroidism

Objective To evaluate the effects of lithium carbonate on serum TSH, FT 3, FT 4 and thyroid mass volume in patients with Graves' hyperthyroidism treated with 131 I. Methods Thirty patients with newly diagnosed, untreated Graves' disease (GD) and nonsevere or absent Graves' ophthalmopathy, were randomly assigned to group 1 and group 2. The 1st group was treated with 131 I therapy only, the 2nd group with 131 I plus lithium carbonate. All subjects were evaluated for changes in serum TSH, FT 3 and FT 4 as well as thyroid mass volume at the 7, 14, 30 d after 131 I therapy. Differences between the two groups in thyroid mass volume, serum FT 4, FT 3, and TSH levels at each interval were evaluated by ANCOVA. Results Serum FT 4 and FT 3 levels increased shortly after 131 I therapy only in group 1, and decreased in group 2. The differences of serum FT 3 and FT 4 levels between the two groups were significant. Conclusion It is important for GD patients to accept lithium carbonate treatment and 131 I therapy simultaneously in order to decrease the serum FT 3 and FT 4 levels caused by 131 I therapy.