Clinical effect of small dose of iodine-131 combined with methimazole in the treatment of hyperthyroidism and its effect on patients with bone turnover markers and bone mineral density

摘要

Objective:To investigate the clinical effect of small dose of iodine-131 combined with methimazole in the treatment of hyperthyroidism and its effect on patients with bone turnover markers and bone mineral density.Methods:A total of 156 patients with hyperthyroidism who were treated in Wuxi No.2 People's Hospital from January 2013 to January 2014 were selected as research subjects. All of the patients were randomly assigned into observation group (n=78) and control group (n=78). All of the patients in the two groups were treated with methimazole orally, and the observation group was received small dose of iodine-131 on the basis of methimazole. The course of treatment is one year, and follow-up visit was done in 3, 6 and 12 months after treatment. Before and after treatment, the function of thyroid (FT3, FT4, TSH, TT3, TT4), bone turnover markers (CT, BGP, ALP, PINP,β-CTX), and bone mineral density (L2-4 lumbar, radius, hip, and the whole body) of two groups were observed and analyzed. The clinical effect, one-year recurrence rate and incidence of adverse reactions of two groups were compared.Results: Before treatment, there were no statistical differences between the two groups. After treatment, the levels of FT3, FT4, TT3, TT4, CT, BGP, ALP, PINP andβ-CTX of two groups were decreased, along with the treatment time extension decreased more significantly, and the levels of observation group at each time point were lower than the control group at the same period. The levels of TSH of two groups were increased, along with the treatment time extension increased more significantly, and the levels of observation group at each time point were higher than the control group at the same period. The bone mineral density of the two groups were higher than before treatment, and the observation group was higher than the control group. The total effective rate of the observation group was higher than the control group, and the one-year recurrence rate was lower than the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusions: Small dose of iodine-131 combined with methimazole can effectively improve thyroid function, correct abnormal bone turnover and increase bone mineral density. Its clinical effect is better than using methimazole alone, and it can effectively reduce the hypothyroid incidence and one-year recurrence rate, and will not increase the drug adverse reactions.