丙基硫氧嘧啶影响^(131)Ⅰ治疗Graves病疗效的分析  

The effect of pretreatment with propylthiouracil on subsequent ^(131)I therapy in Graves' disease

作　　者：程木华[1] 张子康[1] 许杰华[1] 张勇[1] 莫丛健[1] 张峰[1] 陈维真[1] 

机构地区：[1]中山大学附属第三医院核医学科,广州510630

出　　处：《中华核医学杂志》2007年第6期365-366,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的分析丙基硫氧嘧啶(PTU)对^(131)I 治疗 Graves 病疗效的影响。方法 234例Graves 病患者中,36例首选^(131)Ⅰ治疗者为对照(N)组,经过 PTU 治疗的198例患者随机分为 A、B 组。N 组和 A 组均按甲状腺质量给予^(131)I 2.96 MBq/g,B 组每克甲状腺组织^(131)I 剂量较前2组增加30%。治疗6个月后,比较3组患者的疗效,计算治愈率和近期甲状腺功能减退症(简称甲减)发生率。结果 234例 Graves 病患者^(131)I 治疗总有效率为99.1%。N 组治愈率为86.1%,A 组为68.7%,后者明显低于前者(P<0.05)。B 组治愈率为85.9%,与 N 组差别不大,但与 A 组比较差异有统计学意义(P<0.01)。结论 PTU 可直接影响^(131)I 治疗 Graves 病的近期疗效,但增加每克甲状腺组织的^(131)I 剂量可减少其影响。Objective Anti-thyroid drug might affect thyroidal uptake of 131^I. In this study the effect of propyhhiouracil （ PTU ） pretreatment on 131^I therapy in Graves ＇ disease was evaluated . Methods Thirty-six cases of Graves＇disease without PTU were enrolled as control （N）, and 198 pretreated with PTU were randomized into groups A and B. Patients in groups N and A were given 131^I at dosage of 2.96 MBq per gram of thyroid tissue. Patients in group B had 30% increased dosage. Six months after therapy, the therapeutic effect in group N, A and B was evaluated and the cure rates and the hypothyroidism were compared. Results The therapeutic effective rate of the 234 patients with 131^I was 99.1%. The cure rate in group N was 86.1%, which was markedly higher than that in the group A （68.7%, P 〈 0.05 ）, but similar to group B （85.9%）. The rate was obviously different between groups A and B （P 〈0.01 ）. Conclusion PTU might have negative effect on the effectiveness of radioiodine therapy in Graves＇ disease, but its effect could be overcome by increase of radioactivity dose to the patients.

关 键 词：格雷夫斯病 碘放射同位素 放射疗法 丙硫氧嘧啶 治疗结果 

分 类 号：R581.1[医药卫生—内分泌] R733.7[医药卫生—内科学]