儿童和青少年Graves甲亢患者^131I治疗剂量的分析研究  

The dose analysis of ^131I treatment in pediatric patients with Graves hyperthyroidism

作　　者：郑艳[1] 赵德善[1] 付松海[1] 冯菲[1] 耿会霞[1] 孙琦婷[1] 陆克义[1] 李保军[1] 李思进[1] 

机构地区：[1]山西医科大学第一医院核医学科,太原030001

出　　处：《国际放射医学核医学杂志》2013年第2期69-73,共5页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：山西省回国留学人员科研资助项目（2009101）

摘　　要：目的研究儿童和青少年Graves甲状腺功能亢进症（甲亢）患者接受^131I治疗的剂量范围。方法回顾性分析经临床确诊、对抗甲状腺药物耐药或有临床禁忌证并接受^131I治疗的51例儿童和青少年甲亢患者及150例成年甲亢患者。两组患者均按甲状腺质量不同分为5组：第1组：≤30g、第2组：31～50g、第3组：51～70g、第4组：71～90g和第5组：〉90g，儿童和青少年组与成年组间的各质量组间资料分布具有可比性。儿童和青少年组与成年组患者每克甲状腺组织所给予的^131I治疗剂量分别为（2．41±0．71）MBq／g和（3．27±0．97）MBq／g；总剂量分别为（224．36±130．10）MBq和（354．88±308．04）MBq。全部患者均行集中随访，儿童和青少年组^131I治疗后随访时间为24～83个月（平均32个月），成年组的随访时间为15—62个月（平均23个月），治疗结果分为痊愈、好转、甲减和复发。结果随访结果发现，在接受^131I治疗的儿童和青少年组中，痊愈16例、出现永久性甲减22例、好转12例、复发1例；在成年组患者中，痊愈65例、出现永久性甲减56例、好转25例、复发4例；总有效率分别为98％和97．3％，儿童和青少年组与成年组的治疗疗效之间的差异无统计学意义（χ^2=0．058，P〉0．05）。结论在对抗甲状腺药物耐药或有临床禁忌证的儿童和青少年Graves甲亢患者行^131I治疗时，建议所给予的^131I应为成年人相应甲状腺质量所给^131I总剂量的63％左右或每克剂量的74％左右。Objective To analyze the radioactive ^131I dose of treatment in pediatric patients with Graves hyperthyroidism. Method Fifty one pediatric patients with hyperthyroidism and 150 adult patients with hyperthyroidism were retrospectively analyzed, who were contraindicated or refractory for medical therapy and treated with ^131I in this study. All pediatric and adult patients treated with 131I were divided into five groups according to the thyroid weight. Groupl ： ≤30 g, Group2：31-50 g, Group3：51-70 g, Group4： 71-90 g and Group5 ： 〉90 g. The pediatric patients were comparable to the adult patients in data distribution of the thyroid weight. All pediatric patients who were either contraindicated or refractory to antithyroid drugs treatment and adult patients received radioactive ^131I treatment with a dose of （2.41±0.71 ）, （3.27±0.97）MBq/g thyroid tissue respectively. The total administrated doses of ^131I in all pediatric and adult patients were （ 224.36 ± 130.10 ） MBq and （ 354.88±308.04 ） MBq respectively. All the pediatric and adult patients treated with ^131I were followed-up （median 32 months, range 24 to 83 months; median 23 months, range 15 to 62 months, respectively）. The treatment results were divided into euthyroid, hyperthyroidism, late-onset hypothyroidism and relapsed. Results The results by followed-up found that 16 and 65 patients became euthyroid, 22 and 56 patients developed late-onset hypothyroidism, 12 and 25 patients still had hyperthyroidism, 1 and 4 patients relapsed after radioiodine therapy in pediatric group and adult group who were treated with ^131I, respectively. The total efficiency was 98% and 97.3%, respectively. There were no statistical significance of treatment effect between pediatric and adult patients （χ^2=0.058, P〉0.05 ）. Conclusion When the radioactive ^131I dose was administrated in pediatric patients with hyperthyroidism, who were contraindicated or refractory for medical therapy, it is recommended that the ratios of total ^131I dose

关 键 词：格雷夫斯病 碘放射性同位素 放射治疗剂量 近距离放射疗法 儿童 青少年 

分 类 号：R581.1[医药卫生—内分泌]