The Influence Of TRAb On Early-onset Hypothyroidism After The Patients With Hyperthyroidism Received(131)~I Treatment

Objective To assess the affection of serum TRAb on short-term prognosis of early-onset hypothyroidism after the patients with hyperthyroidism received radioiodine therapy, To provide available data for clinical diagnosis and treatment in correctly judge the final outcome of early hypothyroidism, and effectively understand and early judge the emergence of late-onset hypothyroidism.Methods There were 62 patients with hyperthyroidism who became early-onset hypothyroidism within 12 months after [3] I treatment in the study.23 male,39 female, mean age 37.4±11.7(range 14-60 years old). The total time of follow-up were 18～36 months. The parameters of the patients including FT3, FT4, TSH and TRAb were collected before and at 3,6,12 months after radioiodine treatment. The results of last time follow-up after [3] treatment were regard as the final thyroid hormone level of patients. The results were statistically analyzed using repeated measures analysis of variance.Results Sixty-two patients with hyperthyroidism who became early-onset hypothyroidism after [3] I therapy were followed up. The outcome of follow-up showed there were 31 patients with hypothyroidism (including group 1:22 cases with rise TRAb and group 2:9 cases with continuing normal TRAb at different time intervals),27 patients with normal thyroid hormones level,4 cases of recurrence. The results showed that the interaction between group effects and time effects were significant (F=4.39, P<0.001), It showed there were significant differences among TRAb values varied trend before and at different time intervals after radioiodine therapy in 4 groups, the multiple comparison showed that TRAb varied trend in cured group was not significantly greater than that in recurrence group(P>0.05), the differences of TRAb values varied trend between any other two groups were statistically significant (P<0.05). Dynamic trend graph showed that excepting hypothyroidism group 2,which group with continuing normal TRAb at different time intervals, TRAb values were significantly higher after 3 months treatment in any other groups, and started to decline in 6 months,and the recovery group decreased slowly than in hypothyroidism group 1, the decreasing level at 12 months is more significant, furthermore, The TRAb values in hypothyroidism group 1, which whether the higher rate or the values at each time point was significantly lower than the other two groups, and at 12 months after treatment had been relatively close to the upper limit of normal, the main effect of the group among TRAb values was significant (F=14.78, P<0.001), Also there were differences among TRAb values at different time intervals(F=19.67, P<0.001)。Conclusions1. The gradual descent of rise TRAb values signified that the patients with early-onset hypothyroidism who being transformed from hyperthyroidism after radioiodine treatment would be likely to be euthyroid.2. The continuing normal of TRAb values at different time intervals showed that the patients with early-onset hypothyroidism who were from hyperthyroidism after radioiodine treatment would be more likely to be late-onset hypothyroidism.