A comparative study of influential factors correlating with early and late hypothyroidism after ^131I therapy for Graves＇ disease  

作　　者：WANG Ren-fei TAN Jian ZHANG Gui-zhi MENG Zhao-wei ZHENG Wei 

机构地区：[1]Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China

出　　处：《Chinese Medical Journal》2010年第12期1528-1532,共5页中华医学杂志（英文版）

摘　　要：Background 131Ⅰ therapy is recognized as the simplest, safest, least expensive, and most effective treatment, and accepted by more and more patients. However its curative effect is influenced by many factors, therefore there are some difficulties for doctors to establish individual treatment strategy. The aims of this study were to determine the incidence of early and late hypothyroidism after 131Ⅰ treatment for Graves＇ disease （GD） and to compare their correlation, to observe and analyze the influential factors and to understand the predictabilities of them.Methods Five hundred GD patients （144 males, 356 females; age （41.2±12.3） years） received 131Ⅰ treatment for the first time. The therapeutic procedure was carried out as the following： undergoing 131Ⅰ uptake test to obtain maximum of thyroid uptake value and effective half-life （EHL） time; estimating the thyroid＇s weight by ultrasonography; determination of thyroid hormones and correlative antibodies; pre-therapy physical examination; thyroid imaging; calculating 131Ⅰtherapeutic dosage; per os uptake of the determined 131Ⅰ dosage; follow-up appraisal of curative effect. The observing parameters included age, gender, thyroid weight, GD duration, condition of onset, state of disease, course of treatment, EHL time, maximum of thyroid uptake value, 131Ⅰ dosage and titer of correlative antibodies. We sorted out the data and used both univariate and multivariate analysis to evaluate them statistically.Results The incidence rates of early and late hypothyroidism were 33.2% and 6.6% respectively after 131Ⅰ treatment and approximately 22.2% cases of late hypothyroidism developed from early hypothyroidism. The influential factors of early hypothyroidism included course of GD, the highest thyroid uptake ratio of 131Ⅰ, EHL time and thyroid microsome antibody （TMAb）, etc. A multivariate analysis on late hypothyroidism showed that female patients, with recurrence after anti-thyroid drug treatment and higher thyroid weight, had lBackground 131Ⅰ therapy is recognized as the simplest, safest, least expensive, and most effective treatment, and accepted by more and more patients. However its curative effect is influenced by many factors, therefore there are some difficulties for doctors to establish individual treatment strategy. The aims of this study were to determine the incidence of early and late hypothyroidism after 131Ⅰ treatment for Graves＇ disease （GD） and to compare their correlation, to observe and analyze the influential factors and to understand the predictabilities of them.Methods Five hundred GD patients （144 males, 356 females; age （41.2±12.3） years） received 131Ⅰ treatment for the first time. The therapeutic procedure was carried out as the following： undergoing 131Ⅰ uptake test to obtain maximum of thyroid uptake value and effective half-life （EHL） time; estimating the thyroid＇s weight by ultrasonography; determination of thyroid hormones and correlative antibodies; pre-therapy physical examination; thyroid imaging; calculating 131Ⅰtherapeutic dosage; per os uptake of the determined 131Ⅰ dosage; follow-up appraisal of curative effect. The observing parameters included age, gender, thyroid weight, GD duration, condition of onset, state of disease, course of treatment, EHL time, maximum of thyroid uptake value, 131Ⅰ dosage and titer of correlative antibodies. We sorted out the data and used both univariate and multivariate analysis to evaluate them statistically.Results The incidence rates of early and late hypothyroidism were 33.2% and 6.6% respectively after 131Ⅰ treatment and approximately 22.2% cases of late hypothyroidism developed from early hypothyroidism. The influential factors of early hypothyroidism included course of GD, the highest thyroid uptake ratio of 131Ⅰ, EHL time and thyroid microsome antibody （TMAb）, etc. A multivariate analysis on late hypothyroidism showed that female patients, with recurrence after anti-thyroid drug treatment and higher thyroid weight, had l

关 键 词：Graves＇ disease ^131I therapy HYPOTHYROIDISM effective half-life time thyroid microsome antibody 

分 类 号：R[医药卫生]