Graves甲亢合并贫血患者的临床特征 和131I治疗效果的分析

Analysis of clinical features and efficacy of 131I treatment for patients with Graves' hyperthyroidism and anemia

    摘要
  • 摘要:
    目的 分析Graves甲状腺功能亢进症（简称甲亢）合并贫血患者的临床特征并评价131I治疗的效果。
    方法 回顾性分析2018年1月至2019年12月在中国科学技术大学附属第一医院行131I治疗的164例男性32例、女性132例，年龄（45.47±13.44）岁Graves甲亢患者的临床资料，根据是否合并贫血将患者分为贫血组（77例）和普通组（87例）。分析贫血组患者的贫血严重程度和细胞学分类，分析和比较2组患者经131I治疗后血红蛋白浓度（HGB）的变化、临床特点及131I治疗甲亢的疗效。计量资料的比较采用两独立样本t检验，计数资料的比较采用卡方检验。
    结果 在贫血组中，轻、中度贫血患者分别占92.21%（71/77）、7.79%（6/77）；正常细胞性、小细胞低色素性和大细胞性贫血分别占57.14%（44/77）、41.56%（32/77）、1.30%（1/77）。131I治疗后2~4周，贫血组的HGB恢复率为67.53%（52/77），贫血组（104.19±10.56） g/L对（120.90±16.20） g/L和普通组的HGB（126.28±10.09） g/L对（137.84±10.41） g/L较治疗前均明显增高（t=−12.40、−12.57，均P<0.05）。2组Graves甲亢患者在年龄、性别比、甲状腺质量、131I治疗剂量及每克甲状腺组织131I剂量方面的差异均无统计学意义（t或χ2值分别为0.06、0.00、0.30、−0.62、−0.04，均P>0.05）。2组患者Graves甲亢总治愈率为87.20%（143/164），贫血组和普通组的治愈率分别为87.01%（67/77）和87.36%（76/87），且差异无统计学意义（χ2=0.00，P>0.05）。
    结论 Graves甲亢合并贫血患者以轻度、正常细胞性贫血多见，其131I治疗效果与普通的Graves甲亢患者类似，大部分患者的HGB在131I治疗后短期内可恢复正常。

     

    Abstract:
    Objective To analyze the clinical characteristics of Graves' hyperthyroidism in patients with anemia and evaluate the efficacy of 131I treatment.
    Methods A total of 164 patients with Graves' hyperthyroidism (32 males and 132 females; aged 45.47±13.44 years) who underwent 131I treatment at the First Affiliated Hospital of USTC from January 2018 to December 2019 were retrospectively studied. They were divided into the anemia group (n=77) and general group (n=87) according to patients with or without anemia. The severity of anemia and cytological classification in the anemia group were analyzed. Changes in hemoglobin concentration after 131I treatment, clinical features, and the efficacy of 131I treatment were analyzed and compared between groups. The measurement data were compared using two independent sample t-test, and the counting data were compared using chi-square test.
    Results In the anemia group, mild anemia and moderate anemia accounted for 92.21% (71/77) and 7.79% (6/77) of the cases, respectively. Normocytic anemia, microcytic hypochromic anemia, and macrocytic anemia accounted for 57.14% (44/77), 41.56% (32/77), and 1.30% (1/77), respectively. Two to four weeks after 131I treatment, the hemoglobin recovery rate in the anemia group was 67.53% (52/77), and the hemoglobin concentrations in both groups significantly increased anemia group: (104.19±10.56) g/L vs. (120.90±16.20) g/L, general group: (126.28±10.09) g/L vs. (137.84±10.41) g/L; t=−12.40, −12.57, both P<0.05. No statistically significant differences in age, sex ratio, thyroid weight, 131I dose, and 131I dose per gram of thyroid tissue were found between the groups (t or χ2=0.06, 0.00, 0.30, −0.62, −0.04, respectively, all P>0.05). The total curative rate for hyperthyroidism was 87.20% (143/164), the curative rate in the anemia and general groups were 87.01% (67/77) and 87.36% (76/87), respectively. No statistically significant difference in the efficacy of 131I treatment was found between the groups (χ2=0.00, P>0.05).
    Conclusions Mild normocytic anemia was more common in patients with Graves' hyperthyroidism and anemia, and the efficacy of 131I treatment for these patients was similar to that for patients with Graves' hyperthyroidism but without anemia. The hemoglobin concentration of most patients with Graves' hyperthyroidism and anemia returned to normal immediately after 131I treatment.

     

    • HTML全文
    • 参考文献(14)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回