131’I治疗Graves’病临床效果及其影响因素的研究  

The research of clinical therapeutic effect in 131^I treatment of Graves＇ disease and affecting factors

作　　者：邓波[1] 李裕明[1] 江帆[1] 陈璐璐[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院内分泌科,武汉430022

出　　处：《临床内科杂志》2011年第9期597-600,共4页Journal of Clinical Internal Medicine

摘　　要：目的评价Graves’病131^I治疗1年后的临床效果，探讨影响其疗效的因素。方法182例131^I治疗患者疗效按成功治愈（正常＋甲减）、治疗失败（仍为甲亢＋复发）分组，比较两组的性别、年龄、甲状腺重量、摄碘率、FT3、FT4、给定的131^I即131^I治疗系数、131^I剂量、单位质量甲状腺组织131^I剂量。Logistic回归分析甲状腺重量、单位质量甲状腺组织131^I剂量、FT4、131^I治疗系数4个因素与成功治愈概率的关系。结果131^I治疗1年后共随访到114例，仍为甲亢者32例（28％），恢复正常者41例（36％），转为甲减者37例（32．5％），复发者4例（3．5％）。成功治愈率为68．4％，失败率为31．6％。成功治愈组治疗前的甲状腺大小、FT4水平低于治疗失败组，131^I治疗系数、单位质量甲状腺组织131^I剂量明显高于治疗失败组。Logistic回归分析中，单位质量甲状腺组织131^I剂量对成功治愈有统计学意义（P=0．049）。结论Graves’病患者治疗前甲状腺重量、FT4水平、131^I治疗系数、单位质量甲状腺组织131^I剂量是影响131^I治疗效果的因素，并为评估预后的指标；单位质量甲状腺组织131^I剂量与成功治愈独立正相关。Objective To evaluate the clinical therapeutic effect in 131^I treatment of Gravess＇ disease, explore its affecting factors. MethodsThe therapeutic effects was divided into successful cure（ euthy- roidism or hypothyroidism）and unsuccessful cure （persistent or recurrent hyperthyroidism）. Gender,age, thyroid weight,131^I uptake,FT3 ,FT4 ,given 131^I called 131^I treatment coefficient and dose 131^I to thyroid/g tissue were compared in the two groups. The correlation was analysed between the four factors： thyroid weight ,dose 131^I to thyroid/g tissue,FT4 131^I treatment coefficient and successful cure in Logistic Regression. Results After one year 114 subjects had been successfully followed up,32 patients （28%）had persistent hyperthyroidism ,41 （ 36% ） ,37 （ 32.5% ） ,4（ 3.5% ） were euthyroid 、hypothyroid,recurrent hyper-thyroidism respectively. The percentage of successful cure is 68.4% ,unsuccessful cure 31.6%. The thy-roid size and level of serum FT4 before treatment in the successful cure group were lower than the unsuc-cessful group;131^I treatment coefficient and dose 131^I to thyroid/g tissue were obviously higher. Logistic Regression analysis displayed dose 131^I to thyroid/g tissue had a significant impact in successful cure. Conclusion The thyroid weight 、serum FT4 ,131^I treatment coefficient、dose 131^I to thyroid/g tissue can become the indicators of prognosis. Dose 131^I to thyroid/g tissue is independently and positively with success-ful cure.

关 键 词：Graves’病 131^I治疗 

分 类 号：R581.1[医药卫生—内分泌]