影响Graves病131Ⅰ疗效的因素分析  

Factors related to the therapeutic efficacy of 131 Ⅰ in Graves＇ disease

作　　者：周新建[1] 赵媛[1] 朱玉莲[1] 朱迎春[1] 魏来[1] 

机构地区：[1]北京中医药大学东方医院核医学科,100078

出　　处：《中华内分泌代谢杂志》2011年第12期975-978,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的 观察131Ⅰ治疗Craves病（GD）的疗效并分析其影响因素.方法 比较87例患者治疗前后的甲状腺摄碘率（TUR）和有效半衰期（EHL）,甲状腺重量由核素显像及B超重复测量.结果 131Ⅰ治疗剂量为（ 185.2±148.0）MBq,示踪和治疗24 h TUR分别为76.5％±8.2％和73.3％±9.0％（t=2.451,P=0.008）,EHL分别为（5.2±0.7）和（5.0±0.8）d.随访（57.0±26.3）个月,甲状腺功能正常56.3％ （n=49）,晚发甲状腺功能减退16.1％ （n=14）,未愈27.6％ （n=24）.甲状腺抗体阳性34.5％,甲状腺功能减退发生率高于阴性组（30.0％对8.8％,x2=6.560,P=0.009）.结论 治疗剂量131Ⅰ TUR和EHL低于示踪剂量,甲状腺抗体阳性对治疗结果有影响.Objective To explore the efficacy of 131 Ⅰ treatment in Graves＇ disease,and to analyze the related factors.Method In 87 patients with Graves＇ disease,thyroid uptake ratio（ TUR ） and its effective half-life（EHL） were compared before and after 131 Ⅰ treatment.The weight of thyroid gland was evaluated with radio-imaging and type B ultrasonography.Result The dose of 131 Ⅰ was （ 185.2 ± 148.0 ） MBq.The TUR of tracer dose and therapeutic 131 Ⅰ dose were 76.5 % ±8.2% and 73.3 % ±9.0% （ t =2.451,P =0.008 ）.The EHL were （ 5.2±0.7 ） and （ 5.0 ±0.8 ）days,respectively （ t =1.998,P =0.023 ）.After followe-up of （ 57.0 ±26.3 ） months,49 patients （ 56.3 % ） became euthyroid,14 （ 16.1% ）manifested delayed hypothyroidism,and 24 （27.6%）remained in hyperthyroidism.Thyroid autoantibodies were found in 34.5% patients,of whom,the incidence of hypothyroidism was higher in patients with positive autoantibodies than those with negative ones （30.0% vs 8.8%,x2 =6.560,P =0.009 ）.Conclusion Both TUR and EHL of therapeutic doses of 131 Ⅰ are lower than the tracer doses.Positive thyroid autoantibodies may affect the outcome of the 131 Ⅰ treatment.

关 键 词：格雷夫斯病 碘放射性同位素 核素显像 超声检查 甲状腺重量 

分 类 号：R581.1[医药卫生—内分泌]