Comparison of the effect of ¹³¹I and ¹³¹I combined with hepatic protective drug treatment for Graves' disease patients with hepatic dysfunction

Objective: To analyze the change of thyroid hormone levels and hepatic function indices before and after the treatment of ¹³¹I and ¹³¹I combined with a hepatic protective drug in Graves' disease patients with hepatic dysfunction, and to compare their treatment effect. Methods: All 120 patients with Graves' disease, who had hepatic dysfunction associated with Graves' disease, were randomly divided into two groups. Sixty cases in the treatment group received ¹³¹I combined with reduced glutathione tablets, while another 60 cases in the control group underwent ¹³¹I treatment only. FT₃, FT₄, TSH, ALT, AST and total bilirubin (TBIL) of all patients were tested 1 month, 3 months and 6 months after the treatment to evaluate the progress of Graves' disease and hepatic function. FT₃, FT₄ and TSH were detected with electrochemical luminescence method; ALT and AST were detected with rate method; TBIL was detected with diazonium salt method. T-test and χ² test were used for statistical analysis. Results: One, three and six months after ¹³¹I treatment, FT₃ and FT₄ decreased significantly, and TSH increased significantly. FT₃ ≤ (17.13 ±5.22) pmol/L, FT₄ ≤ (51.26 ±20.60) pmol/L, TSH≥ (0.11 ±0.09) mU/L in the treatment group and FT₃≤(17.41 ±5.18) pmol/l, FT₄ ≤(50.60 ±20.45) pmol/L, TSH≥(0.12 ±0.09) mU/L in the control group (t=5.1843-14.8564, all P<0.01). There was no significant difference between the treatment group and the control group (t=0.1478-0.3902, all P>0.05). One month, three months and six months after treatment, the hepatic function indices of patients in the treatment group were significantly decreased (ALT ≤(74.00±26.00) U/L, AST ≤ (68.00 ±27.00) U/L, TBIL ≤ (20.60 ±4.40) μmol/L, t=6.4080-13.8795, all P<0.01). One month after treatment the hepatic function indices of patients in the control group decreased compared to the values before treatment,but there was no significance (t=1.3262-1.9700, all P>0.05). At 3 and 6 months after treatment, the hepatic function indices of these control group patients were significantly reduced (ALT≤ (64.00 ± 17.00) U/L, AST≤ (65.00 ± 16.00) U/L, TBIL≤(21.40 ±4.50) μmol/L; t=6.0144-10.5171, all P<0.01). Six months after treatment,the cure rates of Graves' disease in the treatment group and control group were 80.0% (48/60) and 78.3% (47/60), respectively and the effective rates were 98.3% (59/60) and 95.0% (57/60), respectively (χ²=0.0505, 1.0344, both P>0.05). Hepatic dysfunction cure rates in the treatment group and control group were 88.3% (53/60) and 65% (39/60), respectively and the effective rates were 96.7% (58/60) and 88.3% (50/60), respectively (χ²=9.1304, 8.1067, both P<0.05). Conclusion: ¹³¹I therapy is a good choice for Graves' disease patients with hepatic dysfunction; combined with hepatic protective drug, it can promote the recovery of hepatic function. (authors)