复方碘溶液对格雷夫斯病患者摄131I功能及131I疗效的影响  

Influence of compound iodine solution on 131I uptake and curative effect of 131I therapy in patients with Graves disease

作　　者：柴锦燕[1] 谭建[1] 张桂芝[1] 张瑞国[1] 王任飞[1] Chai Jinyan;Tan Jian;Zhang Guizhi;Zhang Ruiguo;Wang Renfei(Department of Nuclear Medicine,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院核医学科,300052

出　　处：《中华核医学与分子影像杂志》2019年第1期24-27,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金(81501510).

摘　　要：目的探讨停用复方碘溶液不同时间对格雷夫斯病(GD)患者摄131I功能及131I疗效的影响。方法回顾性纳入2012年1月至2016年11月首次接受131I治疗GD的患者1585例(男415例,女1170例;年龄17~62岁),分为预治疗组(131I治疗前服用过复方碘溶液)85例[停用复方碘溶液4~7d组(A组)35例,停用8~14d组(B组)28例,停用15~30d组(C组)22例]和对照组(未服用复方碘溶液)1500例。比较4组患者的最高摄131I率(RAIU)、有效半衰期、131I治疗前的游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平,并进行疗效评价。采用单因素方差分析、Ridit分析和χ^2检验分析数据。结果A^C组与对照组最高RAIU分别为(64.86±13.20)%、(67.40±9.10)%、(73.46±4.65)%和(74.14±9.87)%,差异无统计学意义(F=1.658,P>0.05)。4组有效半衰期差异亦无统计学意义(F=0.651,P>0.05)。A^C组与对照组患者的FT3水平分别为(11.90±4.85)、(15.51±2.95)、(22.08±2.31)和(23.98±4.98)pmol/L(F=13.972,P<0.01),其中A组与B组明显低于对照组及C组(t值:6.57~12.08,均P<0.05);上述4组FT4水平分别为(25.65±11.95)、(32.33±6.25)、(68.41±13.94)和(73.65±21.55)pmol/L(F=21.238,P<0.01),A组与B组FT4水平明显低于对照组及C组(t值:36.09~48.00,均P<0.01)。预治疗组与对照组患者总体疗效比较差异无统计学意义(u=0.397,P>0.05);4组间完全缓解率差异亦未见统计学意义(χ^2=1.169,P>0.05)。结论131I治疗GD前使用复方碘溶液行预治疗,停药后2周内行131I治疗;为避免131I治疗后出现甲亢加重,建议停用4~7d即可行131I治疗。Objective To investigate the influence of different time discontinuation of compound iodine solution on 131I uptake and curative effect of 131I therapy in patients with Graves disease(GD).Methods A total of 1 585 patients(415 males,1 170 females;age range:17-62 years)treated with 131I therapy for the first time between January 2012 and November 2016 were enrolled in this retrospective study.All patients were divided into preliminary treatment group(n=85)and control group(no iodine solution taking,n=1 500).Preliminary treatment group including 4-7 d discontinuation subgroup(group A,n=35),8-14 d discontinuation subgroup(group B,n=28)and 15-30 d discontinuation subgroup(group C,n=22).The highest radioactive iodine uptake(RAIU),effective half-life,free triiodothyronine(FT3)and free thyroxine(FT4)levels before 131I therapy were compared,and curative effects were evaluated.One-way analysis of variance,Ridit analysis and χ^2 test were used to analyze the data.Results The highest RAIU in group A,group B,group C and control group was(64.86±13.20)%,(67.40±9.10)%,(73.46±4.65)% and(74.14±9.87)%,respectively(F=1.658,P>0.05).No significant difference was found in the effective half-life among 4 groups(F=0.651,P>0.05).FT3 level in group A and group B((11.90±4.85)and(15.51±2.95)pmol/L)was significantly lower than that in control group((23.98±4.98)pmol/L)and group C((22.08±2.31)pmol/L;F=13.972,t values:6.57-12.08,all P<0.05).FT4 level in group A and group B((25.65±11.95)and(32.33±6.25)pmol/L)was obviously lower than that in control group((73.65±21.55)pmol/L)and group C((68.41±13.94)pmol/L;F=21.238,t values:36.09-48.00,all P<0.01).The overall curative effect of preliminary treatment group and that of control group were not statistically significant(u=0.397,P>0.05),and no significant difference was found in the complete remission rates among 4 groups(χ^2=1.169,P>0.05).Conclusions If pretreatment with compound iodine solution is used before 131I therapy in GD,it is feasible to carry out 131I therapy within 2 weeks afte

关 键 词：格雷夫斯病 放射疗法 碘放射性同位素 碘化物 治疗效果 

分 类 号：R581[医药卫生—内分泌] R817.5[医药卫生—内科学]