碳酸锂联合^131I治疗Graves病68例临床探讨

目的探讨碳酸锂对Graves甲亢患者甲状腺^131I摄取率的影响及监测碳酸锂使用前后血、尿＆一微球蛋白的水平，了解碳酸锂对肾功能的影响。方法对68例^131I摄取率〈50％的Graves甲亢患者，在给予碳酸锂（250mg·次^-1，3次·d^-1）1周前后，分别测定^131I摄取率，以观察碳酸锂对^131I摄取率的影响及治疗前后血、尿β2-微球蛋白的水平。结果68例患者服碳酸锂1周后，最高^131I摄取率达到73．8％，^131I摄取率平均由28．5％±11．7％上升至43．4％±18．30，平均较原有水平提高14．9％±9．40（P〈O．001）；而治疗前后血、尿β2-微球蛋白水平无明显变化。结论碳酸锂能有效提高^131I摄取率不够高的Graves甲亢患者的^131I摄取率，且肾功能正常时，使用碳酸锂1周对Graves病患者肾功能无不良影响。

131I therapy combined with lithium carbonate in 68 cases of Graves disease

Objective To investigate the lithium carbonate in patients with hyperthyroidism of Graves thyroid ^131I uptake rate and monitoring the effect of lithium before and after the use of blood and urine β2-microglobulin level, and to understand the effect of lithium carbonate on renal function. Methods A total of 68 patients with ^131I uptake rate 50% with Graves hyperthyroidism, after receiving lithium carbonate 250 mg tid, 1 week before and after ^131I uptake were determined. We observed the effect of lithium carbonate on the uptake rate of ^131I and treatment before and after blood and urine β2-microglobulin level. Results One week after lithium carbonate in the patients the maximum rate of ^131I uptake reached 73. 8%, and ^131I uptake rate rose from an average of 28. 5% ± 11.7% to 43.4% ± 18. 3%, 14.9% ± 9.4% higher than before （P 〈0. 001）. There was no significant change before and after the treatment in blood and urine β2-microglobulin level. Conclusion Lithium can effectively improve the ^131I uptake rate in patients with Graves hyperthyroidism. The use of lithium carbonate for 1 week in patients with Graves does not have adverse affect on normal renal function.