甲亢低骨量患者131I治疗后干预治疗效果的评价

目的:研究甲亢低骨量患者131I治疗后干预治疗的效果。方法:对100例甲亢低骨量患者,随机分为两组:A组50例,131I治疗后口服钙尔奇D及罗盖全治疗;B组50例,131I治疗后骨质自然恢复。另设C组50例为正常对照组。于131I治疗前、治疗后3、6及12个月测定A、B两组骨密度(BMD),观察其骨质变化并评价治疗效果。结果:(1)A组随治疗时间延长BMD逐渐升高,具有一定的规律性,腰椎(L2-4)骨密度3个月提高明显(t=-2.111,P=0.04)且12个月时达到与C组无统计学差异(t=-2.290,P=0.202)。(2)B组3个月时腰椎BMD有所降低,12个月时升高明显(股骨颈t=-2.327,P=0.043;腰椎(L2-4)t=-2.798,P=0.000)。(3)6个月时两组腰椎骨密度改善幅度出现统计学差异(t=-2.416,P=0.018),12个月时差异显著(t=-3.259,P=0.002)。结论:131I联合钙尔奇D与罗盖全治疗甲亢低骨量患者,其恢复时间及疗效均用131I治疗,能有效防止骨量的进一步下降及减少骨质疏松症的发生。

Evaluation of the Intervention Effect in Patients of Hyperthyroidismwith Low Bone Mass after 131I Treatment

Objective:To investigate the effect of intervention therapy in patients of hyperthyroidism with low bone mass after 131I treatment.Methods:100 cases of hyperthyroidism patients with low bone mass, were randomly divided into two groups: 50 cases in group A, taking Caltrate D and Rocaltrol after 131I treatment; 50 cases in group B, bone natural recovery after 131I treatment. Another 30 cases in group C as normal control group. Before 131I treatment and after 3, 6 and 12 months, groups A and B were measured to observe the changes of bone mineral density (BMD) and evaluate the effect of intervention therapy.Results:(1) Group A: the BMD increased gradually and had a regular change. The lumbar vertebra (L2-4) reached to the level which there was no significant difference compared with that of group C after 12 months treatment (P=0.202>0.05). (2) Group B: the L2-4 had little decrease 3 months later, but increased evidently after 12 months (femoral neck: P=0.043; L2-4: P=0.000).(3) The changing extent of the L2-4 of these two groups appeared significant difference after 6 months (t= -2.416, P=0.018) and the disparity was more evident after 12 months (t= -3.259, P=0.002).Conclusion:The recovery time and curative effect of using 131I combined with Caltrate D and Rocaltrol is superior to using the single 131I treatment. The combined cure can effectively prevent further decrease in bone mass and reduce the occurrence of osteoporosis.