^(131)I治疗Graves病疗效影响因素分析  

Multiple factor analysis of the therapeutic effect in the ^(131)Ⅰ treatment of Graves' disease

作　　者：庞华[1] 谭本旭[1] 罗加[1] 

机构地区：[1]重庆医科大学附属第一医院核医学科,400016

出　　处：《中华核医学杂志》2003年第6期337-338,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的 探讨Graves病^(131)I治疗疗效的影响因素。方法 Graves病患者681例,记录每例患者性别、治疗前年龄、病程、停抗甲状腺药物(ATD)时间、甲状腺24h吸碘率、有效半衰期、T_3、T_4、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TgAb)、甲状腺微粒体抗体(TMAb)、促甲状腺激素受体抗体(TRAb)、甲状腺质量、每克甲状腺组织给予^(131)I剂量及吸收剂量,分级量化每个指标值。对^(131)I治疗疗效按甲状腺功能减退(简称甲低)、治愈、未愈进行评价。用SAS软件CATMOD过程进行多项反应logit模型拟合,行多因素分析。结果 ^(131)I治疗后1年,58.3％的患者治愈,15.0％的患者未愈,26.7％为甲低。年龄、甲状腺24 h吸碘率、有效半衰期、甲状腺质量及每克甲状腺组织给予^(131)I剂量对^(131)I治疗疗效有统计学意义(P<0.05)。结论 对甲状腺24h吸碘率较低、有效半衰期较长和甲状腺较小的年轻患者,应适当减少每克甲状腺组织给予的^(131)I剂量。Objective To study the influencing factors of therapeutic effect in131Ⅰ treatment of Graves' disease. Methods 681 patients were followed up after one year as hypothyroidism, cure or improvement. Logit test was used to analyze the variable parameters before treatment. Results After 1 year 58.3 % of the cases were cured, 15.0% were improved, and 26.7% become hypothyroidism. The outcome of treatment was closely related to the age, thyroid uptake percentage at 24 h, effective half-life, the weight of thyroid and the absorbed dose per gram of thyroid tissue ( P < 0.05) . Conclusion In those young patients whose thyroid uptake percentage at 24 h was lower, the effective half-life was longer and thyroid weight was smaller, the given 131Ⅰ dose per gram tissue of thyroid should be reduced.

关 键 词：^131I GRAVES病 治疗 影响因素 疗效 格雷夫斯病 碘放射性同位素 

分 类 号：R817.5[医药卫生—影像医学与核医学]