Efficacy Analysis Of ¹³¹I And Medicine In The Treatment Of Hyperthyroidism Patients Complicated With Jaundice

Hyperthyroidism complicated with liver damage is common,but most patients have elevation of transaminase in varying degrees,patients with jaundice are relatively rare and lack of specificity in clinical manifestations,the treatment is difficult.In this paper,the patients with hyperthyroidism combined with jaundice were treated with two different ways of ¹³¹I and medicine.The results were analyzed retrospectively,in order to provide theoretical guidance for the diagnosis and treatment..Objective:Comparative analysis of ¹³¹I and internal medicine in the treatment of hyperthyroidism patients with jaundice.Methods:Sixty-five patients with hyperthyroidism complicated with jaundice from December 2013 to June 2017 hospitalized in our hospital were chosen.The gender,age,duration of hyperthyroidism,medication and other general data of patients were collected,liver function,thyroid function,hepatitis virus markers,autoantibodies and other data were recorded.According to the way of treating hyperthyroidism,they were divided into ¹³¹I treatment group?36 cases?and medical treatment group?29 cases?.According to the degree of bilirubin,the patients were divided into mild jaundice group?30 cases?,moderate jaundice group?13 cases?and severe jaundice group?22cases?,thyroid function,liver function and follow-up data were recorded at 1 week?7±1 day?,3 months?90±7 days?and 6 months?180±14 days?after treatment.The data were analyzed by case-control method and SPSS 18.0 software.Results:1.Of the 65 patients with hyperthyroidism complicated with jaundice,28patients?43.0%?were caused by hyperthyroidism,25 patients?38.5%?with drug-induced liver injury,4 patients?6.2%?by viral hepatitis,1 patients?1.5%?with primary biliary cholangitis,and 7 patients?10.8%?with cirrhosis.2.There was no statistical difference in sex,age and course of disease between the treatment groups of ¹³¹I and medicine?P>0.05?.The levels of FT₃ and FT₄ in the¹³¹I treatment group were higher than those in the medical treatment group,but the difference was not statistically significant?P>0.05?.The proportion of moderate and severe jaundice patients in the ¹³¹I treatment group was larger than that in the medical treatment group?P<0.05?.The liver function indexes of ¹³¹I treatment group were higher than those of medical therapy group,the difference was statistically significant?P<0.05?.3.Patients with mild jaundice:One week after therapy,there was no statistical difference in AST,ALT,TBi L,DBiL and IBi L levels between the two groups?P<0.05?.Three months after treatment,the level of liver function indexes was no statistical difference between the two groups?P>0.05?.The levels of FT₃ and FT₄ in the ¹³¹I treatment group were lower than those in the medical treatment group,and the TSH level was higher than that in the medical treatment group,but only the difference in FT₄ is statistically significant?P<0.05?.Six months after treatment,the levels of FT₃ and FT₄ in the ¹³¹I treatment group were lower than those in medical treatment group,and the TSH level was higher than that in medical treatment group,but only the difference in FT₃ was significant and had statistical significance?P<0.05?.The ALT level in the medical treatment group was higher,the difference was statistically significant?P<0.05?.4.Patients with moderate jaundice:One week after treatment,the levels of AST,ALT,TBiL,DBi L and IBiL in ¹³¹I treatment group were higher than those in medical treatment group,there was significant difference in the levels of IBi L between the two groups?P<0.05?.Three and six months after the treatment,the FT_3,FT_4,TSH,AST,ALT,TBi L,DBiL and IBiL levels between the two groups was no statistical difference?P>0.05?.5.Patients with severe jaundice:One week after treatment,the levels of TBiL,DBiL and IBi L in ¹³¹I treatment group were higher than those in medical treatment group,while the levels of AST and ALT were lower,there was a significant difference in TBi L,DBiL and IBiL levels between the two groups(?P<0.05?.Three months after treatment,the levels of FT_3,FT_4,AST,ALT,TBiL,DBiL and IBi L in ¹³¹I treatment group were lower than those in medical treatment group.there were significant differences in TBi L,DBi L and IBi L levels between the two groups?P<0.05?.Six months after treatment,the levels of FT_3,FT_4,AST,ALT,TBi L,DBiL and IBiL in ¹³¹I treatment group were lower than those in medical treatment group,and TSH levels were higher,but the difference was not statistically significant?P>0.05?.Conclusion:For patients with different degrees of jaundice,¹³¹I therapy is superior to medical therapy in the recovery of thyroid function and liver function,and is worth recommending for clinical use.