Graves病甲状腺硬度对~(131)I治疗影响的初步分析
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摘要
目的探讨Graves病甲状腺硬度对~(131)I治疗的影响。方法选择于我院接受~(131)I治疗的150例Graves病患者,于治疗前接受剪切波弹性成像(SWE)检查。所有患者~(131)I治疗后随访观察一年得到疗效评价结果。结果无效组的弹性模量值(Emean和Emax)明显高于临床痊愈组、好转组及甲减组,差异具有统计学意义(P<0.05);TGAb (>60IU/ml)组的弹性模量值(Emean、Emin)明显高于TGAb (<60IU/ml)组,TRAb (>30U/L)组的弹性模量值(Emean、Emin、Emax)明显高于TRAb (1.5～30U/L)组,差异具有统计学意义(P<0.05)。Graves病甲状腺弹性模量值(Emean)与TRAb血清水平呈弱正相关(r=0.302,P<0.05)。结论 Graves病治疗前甲状腺硬度对~(131)I治疗有影响,并有望为临床131I治疗的疗效观察、预后评估及治疗的指导提供一定的参考依据。
Objective To explore the effect of thyroid stiffness on ~(131) I therapy in Graves disease.Methods 150 patients scheduled ~(131) I therapy with Graves disease in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University underwent shear wave elastography(SWE)before treatment.All patients were followed up for one year after ~(131) I therapy to obtain the results of efficacy evaluation.Results The elastic modulus values(Emean and Emax)of the invalid group were higher than those of the clinically cured group,improved group,and hypothyroidism group,and the difference was statistically significant(P<0.05).Compared with TGAb(<60 IU/ml),the elastic modulus values(Emean and Emin)of TGAb(>60 IU/ml)were higher.Compared with TRAb(1.5-30 U/L)group,the elastic modulus values(Emean,Emin and Emax)of TRAb(>30 U/L)group were higher.The difference was statistically significant(P<0.05).There was a weak positive correlation between the elastic modulus value(Emean)of thyroid tissue with Graves disease and the serum levels of TRAb(r=0.302,P<0.05).Conclusions Thyroid stiffness of Graves disease before treatment has an effect on ~(131) I therapy.It is expected to provide a certain reference for the observation of curative effect,evaluation of prognosis and treatment guidance of clinical ~(131) I therapy.
Objective To explore the effect of thyroid stiffness on ~(131) I therapy in Graves disease.Methods 150 patients scheduled ~(131) I therapy with Graves disease in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University underwent shear wave elastography(SWE)before treatment.All patients were followed up for one year after ~(131) I therapy to obtain the results of efficacy evaluation.Results The elastic modulus values(Emean and Emax)of the invalid group were higher than those of the clinically cured group,improved group,and hypothyroidism group,and the difference was statistically significant(P<0.05).Compared with TGAb(<60 IU/ml),the elastic modulus values(Emean and Emin)of TGAb(>60 IU/ml)were higher.Compared with TRAb(1.5-30 U/L)group,the elastic modulus values(Emean,Emin and Emax)of TRAb(>30 U/L)group were higher.The difference was statistically significant(P<0.05).There was a weak positive correlation between the elastic modulus value(Emean)of thyroid tissue with Graves disease and the serum levels of TRAb(r=0.302,P<0.05).Conclusions Thyroid stiffness of Graves disease before treatment has an effect on ~(131) I therapy.It is expected to provide a certain reference for the observation of curative effect,evaluation of prognosis and treatment guidance of clinical ~(131) I therapy.
引文
[1]杨继文,葛俊亮,高光健,等.131I治疗Graves病早期疗效及影响因素分析[J].皖南医学院学报,2018,37(4):378-380.
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[3]刘海芳,朱玉萍.实时剪切波弹性成像技术在亚急性甲状腺炎中的诊断价值及与血沉的关系[J].中国超声医学杂志,2016,32(4):292-294.
[4] LIU J,ZHANG Y,JI Y,et al.The value of shear wave elastography in diffuse thyroid disease[J].Clinical Imaging,2018,49:187-192.
[5]吴邦国,杨静升,高小宏.甲亢患者131I治疗前后TRAb的变化分析[J].系统医学,2017,2(24):29-31.
[2]雷国龙,陆永萍,吕燕芬,等.实时剪切波超声弹性成像对正常甲状腺的定量研究[J].中国超声医学杂志,2015,31(2):101-103.
[3]刘海芳,朱玉萍.实时剪切波弹性成像技术在亚急性甲状腺炎中的诊断价值及与血沉的关系[J].中国超声医学杂志,2016,32(4):292-294.
[4] LIU J,ZHANG Y,JI Y,et al.The value of shear wave elastography in diffuse thyroid disease[J].Clinical Imaging,2018,49:187-192.
[5]吴邦国,杨静升,高小宏.甲亢患者131I治疗前后TRAb的变化分析[J].系统医学,2017,2(24):29-31.