计算剂量方案行格雷夫斯病甲状腺功能亢进放射性碘治疗的疗效分析  

Analysis of therapeutic effect of empirically calculated dose of radioiodine therapy on hyperthyroidism of Graves disease

作　　者：傅宏亮[1] 杜学亮[1] 李佳宁[1] 马超[1] 吴震宇[1] 吴书其[1] 叶智轶[1] 冯方[1] 陈素芸[1] 王辉[1] 蒋宁一[2] 

机构地区：[1]上海交通大学医学院附属新华医院核医学科,上海200092 [2]中山大学孙逸仙纪念医院核医学科,广州510000

出　　处：《上海交通大学学报（医学版）》2014年第7期1039-1042,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：公益性行业科研专项课题(200802028)~~

摘　　要：目的分析计算剂量方案行格雷夫斯病甲状腺功能亢进(Graves甲亢)放射性碘(131I)治疗的效果。方法 299例Graves甲亢患者行131I治疗,根据计算剂量法方案确定131I治疗剂量,分别于131I治疗后3、6个月行甲状腺功能检测以评估疗效,多因素回归分析131I治疗效果的影响因素。结果 299例Graves甲亢患者,131I治疗后3个月治疗有效187例(62.5%),其中甲状腺功能减退(甲减)84例(28.1%);131I治疗后6个月治疗有效248例(83.0%),其中甲减107例(35.8%)。多因素回归分析显示,甲状腺质量、甲状腺最高摄碘率和血清游离三碘甲状腺原氨酸(FT3)水平是Graves甲亢131I治疗效果的主要影响因素(均P<0.05)。结论计算剂量方案行Graves甲亢131I治疗,应充分考虑甲状腺质量、最高摄碘率和血清FT3水平对疗效的影响;计算剂量方案131I治疗较适合于抗甲状腺药物疗效差、复发或有严重不良反应的Graves甲亢患者。Objective To analyze the effects of empirically calculated dose of radioiodine （^131I） therapy on hyperthyroidism of Graves disease. Methods A total of 299 patients with Graves disease underwent the ^131I therapy. The dose of ^131I therapy was determined based on the empirical1y calculated dose. The therapeutic effect was evaluated by the thyroid function test after 3 and 6 months of the treatment. Stepwise multiple regression analysis was performed to identify factors that influenced the effect of the ^131I therapy. Results Among 299 cases of Graves disease, the ^131I therapy was effective for 187 （62.50/0） cases after being treated for 3 months and the incidence of hypothyroidism caused by the treatment was 84 （28.10/0） cases. The ^131I therapy was effective for 248 （83.0%） cases after being treated for 6 months and the incidence of hypothyroidism caused by the treatment was 107 （35.80/0） cases. The multiple regression analysis showed that the weight of thyroid, the maximum radioiodine uptake of thyroid, and the free triiodothyronine （FT3） level were major factors that influenced the effect of the ^131I therapy （P〈0.05）. Conclusion The empirically calculated dose of ^131I therapy for the treatment of Graves disease should take into account the effects of weight of thyroid, the maximum radioiodine uptake of thyroid, and the FT3 level on the therapy. The empirically calculated dose of ^131I therapy is suitable for recurrent patients or patients with poor therapeutic effect for antithyroid drug or severe side effects.

关 键 词：格雷夫斯病 甲状腺功能亢进 放射性碘治疗 计算剂量方案 

分 类 号：R581.1[医药卫生—内分泌]