碘131与口服药物二次治疗对复发型甲亢患者甲状腺功能及骨密度的影响

Objective To explore the effects of iodine-131(131I) and secondary oral medication on thyroid function and bone density in patients with recurrent hyperthyroidism. Methods A total of 110 patients with recurrent hyperthyroidism from April 2024 to April 2025 in our hospital were selected and randomly divided into the reference group(55 cases) and the research group(55 cases). The reference group received secondary oral methimazole treatment for 3 months, while the research group received methimazole oral treatment for 3 months followed by a 7-day drug withdrawal and then a single oral dose of 131I. Changes in thyroid function, oxidative stress, and bone density before and after treatment were observed in both groups. The occurrence of adverse reactions during treatment and the recurrence rate 3 months after treatment cessation were compared between the two groups. Results After treatment, the serum free triiodothyronine(FT3) and free thyroxine(FT4) levels in both groups were lower than those before treatment, and the thyroid stimulating hormone(TSH) levels were higher than those before treatment. The changes in the research group were greater than those in the reference group(P<0.05). The serum superoxide dismutase(SOD) levels in both groups were higher after treatment than before treatment, and the malondialdehyde levels were lower than before treatment. The changes in the research group were greater than those in the reference group(P<0.05). The bone density at the radius, L2 ～ 3 vertebrae, and hip in both groups increased after treatment, and the increase in the research group was greater than that in the reference group(P<0.05). There was no significant difference in the total incidence of adverse reactions during treatment between the two groups(P>0.05), but the recurrence rate in the research group was lower than that in the reference group 3 months after treatment cessation(P<0.05). Conclusion The combination of 131I and secondary oral methimazole treatment can more effectively regulate thyroid function in patients with recurrent hyperthyroidism, reduce oxidative stress, improve bone density, and reduce recurrence without significantly increasing adverse reactions.