| Objective:To explore the early change trend of serum sex hormone and parathyroid hormone in patients with Graves disease（GD）treated with high-dose 131I,and to analyze the correlation between serum sex hormone,parathyroid hormone and thyroid hormone in patients with Graves disease before 131I treatment.Methods:A total of 57 patients with GD who were treated with 131I in the Department of Nuclear Medicine of the first affiliated Hospital of Guangxi Medical University from October 2018 to November 2019 with 131I dose≥555 MBq（15 m Ci）were selected as subjects,including 15 males aged 22-56years and 42 females aged 15-49 years.Parathyroid hormone（PTH）,follicle stimulating hormone（FSH）,luteinizing hormone（LH）,prolactin（PRL）,estradiol（E2）,progesterone P)and testosterone（T）were measured in patients with GD before 131I treatment and 7 days,14 days,1 month and 3 months after131I treatment.The levels of FSH,LH,PRL,E2,P,T and PTH in male and female patients with GD before and after 131I treatment were compared,and the correlations between FSH,LH,PRL,E2,P,T,PTH and triiodothyronine（T3）,thyroxine（T4）,free triiodothyronine（FT3）,free thyroxine（FT4）and thyroid stimulating hormone（TSH）were analyzed.Results:1.Basic characteristics:57 patients with GD were included,including 15 males with a median age of 38.0 years,taking 131I dose 555～2220MBq（740±710 MBq）,42 female patients with a median age of 36.5years old,taking 131I dose 555～1850 MBq（666±333 MBq）.2.Early dynamic monitoring of sex hormone levels in male GD patients after high-dose 131I treatment:the T level of male GD patients decreased significantly 14 days after 131I treatment,and decreased to 2.30±6.58 ng/ml（P<0.05）3 months after 131I treatment.The T level of 12 male GD patients before treatment was higher than the upper limit of the normal range,and returned to the normal range of 9 male GD patients 3months after treatment.3.Early dynamic monitoring of sex hormone levels in female GD patients after high-dose 131I treatment:PRL of female GD patients began to decrease 14 days after 131I treatment,and decreased significantly from20.65±14.1 ng/ml before treatment to 12.59±4.04 ng/ml（P<0.05）3 months after treatment.The PRL level of 2 female GD patients before treatment was higher than the upper limit of normal range,and decreased to normal reference range 3 months after treatment.The PRL levels of other patients before and 3months after 131I treatment were within the normal reference range.The T level of female GD patients increased slightly from 0.87±0.54 ng/ml to 1.12±0.69ng/ml（P<0.05）14 days after treatment,then decreased gradually,and decreased to 0.92±0.86 ng/ml 3 months after treatment.There was no significant difference between T level 3 months after treatment and that before treatment.4.Early dynamic monitoring of PTH level in GD patients after high-dose 131I treatment:the PTH level of male GD patients increased significantly from 24.47±63.72 pg/ml to 48.54±69.01 pg/ml（P<0.05）3 months after 131I treatment,while the PTH level of female GD patients decreased transiently 7 days after 131I treatment and increased from 29.14±24.65 pg/ml to 52.26±35.00 pg/ml（P<0.05）3 months after treatment.5.Correlation analysis of sex hormone,PTH and thyroid hormone in patients with GD before high-dose 131I treatment:there was a positive correlation between E2 and T3,FT3,FT4（r=0.586、0.686、0.575,all P<0.05）in male patients with GD before treatment,and a negative correlation between PTH and FT3（r=-0.329,P<0.05）in female patients with GD before treatment.PRL was positively correlated with T3 and T4（r=0.469、0.316,all P<0.05）,but no clear correlation was found among other indexes.Conclusion:1.Patients with Graves disease often have gonadal dysfunction.High-dose 131I treatment can regulate the level of sex hormones to a certain extent in the early stage,but no early adverse effects on gonadal function were found.2.PTH is often suppressed in patients with Graves disease.High-dose131I treatment can increase the level of PTH in the early stage,which can be used to monitor the changing trend of PTH to help judge the therapeutic effect of 131I.3.There is a certain correlation between the levels of sex hormones,PTH and thyroid hormones in patients with Graves disease.The determination of sex hormones and PTH levels can provide a scientific basis for judging the degree of thyroid hormone increase in patients with Graves disease. |
