Study Of Thyroid Hormone Levels In Patients With Hyperthyroidism Who Received Only ¹³¹I Therapy And Glucocorticoid Following ¹³¹I Therapy

Objective:Hyperthyroidism is the clinical syndrome resulting from high levels of circulating thyroid hormone. Evidence from clinical practice showed that 131I therapy is an effective treatment option for patients with hyperthyroidism. The aim of the study was to investigate the clinical outcomes in patients treated with glucocorticoid following 131I therapy, and to evaluate its clinical values. Methods:A total of 98 subjects were selected and classified into glucocorticoid following 131I therapy group (study group, n=49) and only 131I therapy group (control group, n=49). Study subjects received 5days of intravenous dexamethasone 2mg daily following administration of 131I. Radioactive iodine uptake rate,estimated thyroid gland weight and theraputic 131I dosage were assessed prior to treatment. Serum TT3, TT4, TSH assays were performed before and one week after treatment. The theraputic outcomes of glucocorticoid following 131I therapy were evaluated by clinical symptoms,signs,thyroid function (TT3, TT4, TSH),clinical control rate and basal metabolic rate. Results In study subjects serum TT3, TT4 levels and basal metabolic rates were significantly decreased after treatment compared to the levels of pre-treatment (P<0.01), in control subjects serum TT3 were significantly increased (P <0.05), TT4 levels and basal metabolic rates were also significantly increased (P<0.01). There were statictical differences in serum TT3, TT4 levels and basal metabolic rates between study group and control group after treatment (P<0.01), and no differences before treatment (P>0.05). Conclusion:Dexamethasone administra- tion following 131I therapy is the preferred treatment for patients with Graves disease. After 131I therapy, symptoms of hyperthyroidism worsen, thyroid crisis may even occur, which are caused by radioactive thyroiditis, release of thyroid hormone from injured thyroid cells. Dexamethasone combination therapy can effectively control the symptoms, decrease the serum TT3,TT4 levels and basal metabolic rate, prevent early complication of 131I therapy, improve the clinical outcomes.