131)I Therapy in Combination with Artificial Liver Support with Molecular Adsorbent Recirculating System for Graves Hyperthyroidism Associated with Severe Liver Damage

Objective To evaluate the curative effects of 131I therapy in combination with artificial liver support with molecular adsorbents recirculating system(MARS) on Graves hyperthyroidism associated with severe liver damage.Methods On the basis of routine treatment,40 patients with Graves hyperthyroidism and severe liver damage were treated with 131I therapy alone(test group,n=20) or in combination with MARS(control group,n=20).The levels of free triiodothyronine(FT3),free thyroxine(FT4),total bilirubin(TBIL) and prothrombin time(PT) were measured on admission,1 and 2 weeks after treatment,and at discharge.In addition,the curative effects were observed 6 months after treatment.Results The total effective rate in test group was significantly higher than that in control group(85% vs 50.0%,P0.01).Compared with values on admission,TBIL,FT3,FT4 and PT significantly decreased at 1 week after routine and MARS treatment in test group(P0.01),but did not change at 1 week after routine treatment in control group(P0.05).Compared with values before treatment,TBIL,FT3,FT4 and PT significantly increased at 1 week after 131I therapy in both groups(P0.05),but obviously decreased at 2 week after 131I therapy in test group(P0.01),and did not change in control group(P0.05).There were no significant differences in values of TBIL,FT3,FT4 and PT between the two groups on admission(P0.05),but these values in test group were significantly lower than those in control group at discharge(P0.01).Furthermore,these values on admission were obviously lower than those at discharge in both groups(P0.05 or P0.01).Conclusion The combined treatment of 131I therapy and artificial liver support with MARS can quickly improve liver function and high metabolic state,increase the safety and efficacy of 131I therapy,and improve the prognosis in patients with Graves hyperthyroidism associated with severe liver damage.