431例甲状腺功能亢进症患者^(131)I治疗临床分析  

Clinical study of 431 cases with hyperthyroidism after radioiodine therapy

作　　者：程义壮[1,2] 夏俊勇[2] 金晓毛[2] 姚晓波[2] 张然[2] 潘发明[1] 

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]安徽医科大学附属省立医院核医学科,合肥230001

出　　处：《安徽医学》2013年第3期260-263,共4页Anhui Medical Journal

摘　　要：目的探讨个体化131I剂量治疗甲亢疗效的影响因素。方法收集分析431例131I治疗后的甲亢患者资料,包括性别、年龄、病程、症状、体征、实验室检查、甲状腺质量、甲状腺质地、24 h摄碘率、每克甲状腺组织131I剂量,对数据进行分析。结果131I治疗后3个月痊愈156例(36.19%)、未愈275例(63.81%)、甲减87例(20.19%);6个月痊愈244例(56.61%)、未愈187例(43.39%)、甲减197例(45.71%);9个月痊愈270例(62.65%)、未愈161例(37.35%)、甲减189例(43.85%);1年痊愈283例(65.66%)、未愈148例(34.34%)、甲减184例(42.69%)。对131I治疗后1年的痊愈组和未愈组数据行单因素分析,筛选出病程(Z=-2.434,P=0.015)、甲状腺质量(t=5.725,P=0.000)、24 h摄131I率(t=2.431,P=0.015)、FT3(t=3.990,P=0.000)和每克甲状腺组织131I剂量(χ2=26.649,P=0.000)是可能影响131I治疗甲亢的相关因素。Logistic多因素回归分析显示病程(P=0.028)和每克甲状腺组织131I剂量(P=0.000)是影响131I治疗甲亢痊愈的因素。结论131I治疗甲亢的疗效良好,但甲减的发生率也较高。病程和每克甲状腺组织131I剂量是影响131I疗效的主要因素。采用个体化131I剂量治疗,需考虑多种因素影响,以提高治愈率、同时降低甲减发生率。Objective To investigate the relationship of the treatment effeets and factors ＇affecting the treatment effeets of individual 131I dose therapy for hyperthyroidism. Methods Four hundred and thirty one cases of hyperthyroidism, including 115 male and 316 female, were retrospectively studied .The mean age was （38.32±12.34）years. Hyperthyroidism patients were given individual 131I dose of mean （7.26± 3.68） MBq per gram of thyroid tissue.The term of follow-up was one year.Date including sex, age, course of disease, symptoms, signs, blood tests, mass of thyroid, texture of thyroid, radioactive iodine uptake （RAIU） and dose of 131I per gram of thyroid tissue were collected. Indepen- dent samples test, chi-square test, mann-whitney test and multi-variant logistic regression were performed. Results Three months after ,3q therapy, 156 patients （36.19%） were well-healed, 275 patients （63.81%） were partially remitted or showed no changes, and 87 patients （20.19%） suffered from early hypothyroidism. Six months after 131I therapy, 244 patients （56.61%） were well-healed, 187 patients （43.39%） were partially remitted or showed no changes, and 197 patients （45.71%） suffered from early hypothyroidism. Nine month after 131I therapy, 270patients （62.65%） were well-healed, 161 patients （37.35%） was partially remitted or showed no changes, and 189 patients （43.85%） suffered from early hypothyroidism. One year after 131I therapy, 283 patients （65.66%） were well-healed, 148 patients （34.34%） was partially remitted or showed no changes, and 184 patients （42.69%） suffered from early hypothyroidism. Course of disease（Z=-2.434, P=0.015 ）, mass of thyroid （ t=-5.725, P=-0.000）, RAIU （ t=2.431, P =0.015 ）, FT3 （ t=3.990,/9=0.000）and dose of 131I per gram of thyroid tissue （X~=26.649, P=0.000）were closely related to the outcome of 13q therapy by uni-variant analyses. Multi-variant logistic regression showed course of disease（Wald=4.820,19= O.028）and dose o

关 键 词：甲状腺功能亢进症 放射疗法 碘放射性同位素 随访研究 

分 类 号：R581.1[医药卫生—内分泌]