RESUMO
Objective:To investigate the therapeutic effect of levo-thyroxine ( L-T 4) gel on hypothyroidism in rat model. Methods:A total of 30 Wistar rats (15 males, 15 females, 2-month age) were completely randomized into 6 groups ( n=5 per group) with one group as the normal control and the other 5 groups were established as the hypothyroidism models by intraperitoneal injection of 18.5 MBq 131I. Of the 5 hypothyroidism groups, 3 groups were given 0.2 g (high-dose group), 0.1 g (medium-dose group) and 0.05 g (low-dose group) L-T 4 gel per 100 g body mass on alternate days, respectively, one group was given 0.1 g blank gel per 100 g body mass daily and the other group was given 5 μg levo-thyroxine sodium tablets (Euthyrox) per 100 g body mass daily. The levels of total thyroxine (TT 4), free triiodothyronine (FT 3), free thyroxine (FT 4) and thyroid stimulating hormone (TSH) in serum were determined by radioimmunoassay and chemiluminescence immunoassay at 2, 4 and 8 weeks after administration, respectively. One-way analysis of variance and Bonferroni test were used for data analysis. Results:At 2 weeks after administration, compared with the normal control group, TT 4, FT 4 decreased and TSH increased in the oral Euthyrox group (TT 4: (65.04±8.20) vs (40.34±1.41) nmol/L, FT 4: (29.63±4.03) vs (18.03±2.76) pmol/L, TSH: (6.04±0.80) vs (10.07±1.01) mU/L; F values: 60.081-108.128, t values: from -4.44 to 4.86, all P<0.05). However, TT 4 ((67.88±14.27) nmol/L), FT 3 ((4.04±0.84) vs (4.45±0.34) pmol/L), FT 4 ((33.76±7.71) pmol/L) and TSH ((8.20±0.40) mU/L) in the L-T 4 gel low-dose group showed no significant differences with the normal control group ( t values: 0.44-2.61, all P>0.05). At 4 weeks after administration, there were no significant differences of TT 4, FT 3, FT 4 and TSH between the L-T 4 gel low-dose group/the oral Euthyrox group and the normal control group ( F values: 34.527-90.976, t values: from -0.95 to 0.35, all P>0.05). The differences of TT 4, FT 3, FT 4 and TSH were not significant between the L-T 4 gel low-dose group and the oral Euthyrox group ( t values: from -0.71 to 1.03, all P>0.05), which was still not significantly different at 8 weeks ( F values: 47.239-160.679, t values: from -0.58 to 1.02, all P>0.05). Conclusions:L-T 4 gel has obvious therapeutic effect on hypothyroidism in rats. Its effect is fast and stable, and its therapeutic effect is better than L-T 4 sodium tablets (Euthyrox).
RESUMO
Objective To investigate the influence of different time discontinuation of compound iodine solution on 131Ⅰ uptake and curative effect of 131Ⅰ therapy in patients with Graves disease (GD).Methods A total of 1 585 patients (415 males,1 170 females;age range:17-62 years) treated with 131Ⅰ therapy for the first time between January 2012 and November 2016 were enrolled in this retrospective study.All patients were divided into preliminary treatment group (n =85) and control group (no iodine solution taking,n =1 500).Preliminary treatment group including 4-7 d discontinuation subgroup (group A,n=35),8-14 d discontinuation subgroup (group B,n=28) and 15-30 d discontinuation subgroup (group C,n=22).The high-est radioactive iodine uptake (RAIU),effective half-life,free triiodothyronine (FT3) and free thyroxine (FT4) levels before 131Ⅰ therapy were compared,and curative effects were evaluated.One-way analysis of variance,Ridit analysis and x2 test were used to analyze the data.Results The highest RAIU in group A,group B,group C and control group was (64.86 ± 13.20) ％,(67.40 ± 9.10) ％,(73.46 ± 4.65) ％ and (74.14±9.87) ％,respectively (F =1.658,P＞ 0.05).No significant difference was found in the effective half-life among 4 groups (F=0.651,P＞0.05).FT3 level in group A and group B ((11.90±4.85) and (15.51±2.95) pmol/L) was significantly lower than that in control group ((23.98±4.98) pmoL/L) and group C ((22.08±2.31) pmol/L;F=13.972,t values:6.57-12.08,all P＜0.05).FT4 level in group A and group B ((25.65±11.95) and (32.33±6.25) pmol/L) was obviously lower than that in control group ((73.65±21.55) pmol/L) and group C ((68.41±13.94) pmo]/L;F=21.238,t values:36.09-48.00,all P＜0.01).The overall curative effect of preliminary treatment group and that of control group were not statistically significant (u=0.397,P＞0.05),and no significant difference was found in the complete remission rates among 4 groups (x2 =1.169,P＞0.05).Conclusions If pretreatment with compound iodine solution is used before 131Ⅰ therapy in GD,it is feasible to carry out 131Ⅰ therapy within 2 weeks after withdrawal.In order to avoid the possibility of severe hyperthyroidism after 131Ⅰ therapy,it is recommended that radioiodine treatment should be carried out after discontinuation for 4-7 d.
RESUMO
To explore the long-term effects of L-T4 treatment on physical and intellectual development in neonatal congenital hypothyroidism(CH) patients during adolescence and adulthood.14 out of 15 patients,aged 15-31 years old,including 9 males and 6 females,were diagnosed by neonatal screening for congenital hypothyroidism.(1) By treatment for 10 years until adolescence,return visit ages were 12.6-18.1 years old,the height of patients were normal in 14 cases,weight normal in 8 cases,and overweight in 6 cases.Only the first patient of neonatal screening for congenital hypothyroidism height 154 cm,weight of 43.5 kg,which were below the standard.Bone age by X-ray showed 9 normal,1 case of rapid development,4 cases with left wrist bone age retardation.IQ combined Raven's test(CRT) showed 3 cases excellent,7 cases normal,3 cases borderline,and 2 cases low.(2)Treatment for more than 20 years to adulthood,9 cases of return visits (8 cases were screened out) by 23-31 years of age,with 5 males and 4 females,height and bone age were all normal,normal weight,only 2 cases BMI slightly overweight.As to IQ,good were in 7 cases,mild retardation in 2 cases.7 patients received above average education;they were all employed except one.The employed patients were all capable for their jobs.In summary,screening out of 8 patients,1 case were of mild mental retardation (12.5％);while 7 patients(87.5％),both in physical and intellectual levels were as those of the normal population.
