剂量计算法^(131)I治疗Graves病甲状腺功能亢进的疗效及其影响因素  

Results and influencing factors of ^(131)I treatment of Graves' hyperthyroidism with dose calculated method

作　　者：顾祯祺[1] 鹿彤[1] 南宇乐[1] 张林娣[1] 李玮[1] 曾纪骅[1] 

机构地区：[1]复旦大学附属上海市第五人民医院核医学科,上海200240

出　　处：《肿瘤影像学》2014年第3期189-192,共4页Oncoradiology

摘　　要：目的探讨剂量计算法131I治疗Graves病甲状腺功能亢进(简称甲亢)的疗效和影响因素。方法回顾分析150例Graves病甲亢患者131Ⅰ治疗结果。按每克甲状腺组织期望给予3.7 MBq固定量,经剂量计算法获得131I总剂量。治疗后随访平均12个月(6~96个月)。根据甲状腺功能随访结果将患者分为治疗成功(正常或甲状腺功能减退)和失败(仍为甲亢,需复治)两组,比较分析两组患者治疗前年龄、性别、病程、ATD治疗经历、突眼、甲状腺重量、3 h与24 h摄碘率及其比值(UR)等各项指标。结果 77.3%(116/150)首次治疗成功,22.7%(34/150)失败。总治愈率为94.6%。首次治疗疗效影响因素在年龄、性别、突眼、有无ATD治疗史、甲状腺重量、3 h摄碘率及UR上差异有统计学意义(P<0.05)。UR≥1和甲状腺重量≥47.38 g时,其治疗失败率分别高于UR<1和甲状腺重量<47.38 g者(P<0.01)。结论剂量计算法131Ⅰ治疗Graves病甲亢有较高的首次治疗成功率,当UR≥1或甲状腺重量≥47.38 g时,应告知患者有131Ⅰ复治可能或应增加剂量以提高一次治愈率。Objective To investigate the results and influencing factors of 131Ⅰtreatment of Graves’ hyperthyroidism with dose calculated method. Methods The therapy outcome of 150 patients with Graves’ hyperthyroidism treated with 131Ⅰ was analyzed retrospectively. The total dose of 131Ⅰgiven to each patient was calculated by dose calculated method according to fixed dose of 3.7 MBq per gram of thyroid tissue. All patients were followed up for median 12 months （6-96 months） after treatment. According to the thyroid function of following up, the patients were divided into the success group （euthyroidism or hypothyroidism） and failure group （those with persistent hyperthyroidism who need repeated 131I therapy）. The pretreatment age, sex, course of disease, antithyroid drug （ATD） treatment experience, exophthalmos, thyroid weight, 3 h and 24 h radioiodine uptake rate and the uptake ratio （UR, 3/24 h radioiodine uptake） were compared between the two groups. Results After the first treatment, of 150 patients with Graves’ hyperthyroidism, 77.3% （116/150） acquired successful treatment, 22.7% （34/150） were failed. The total cure rate was 94.6%. There were significant differences in pretreatment age, sex, exophthalmos, ATD treatment experience, thyroid weight, 3 h radio iodine uptake rate, and UR between the two groups （P〈0.05）. The failure rate in patients with UR≥1 or thyroid weight ≥47.38 g was higher than that in those with UR〈1 or thyroid weight 〈47.38 g （P〈0.01）. Conclusion The results show that 131Ⅰtreatment of Graves’ hyperthyroidism with dose calculated method has high success rate after the first treatment. When UR≥1 or thyroid weight ≥47.38 g, the patients should be informed that they may require a second 131Ⅰ treatment or the adminstration of radioiodine dose should be increased to improve the cure rate.

关 键 词：Graves病甲状腺功能亢进 131Ⅰ治疗 摄取比值 甲状腺重量 

分 类 号：R445.5[医药卫生—影像医学与核医学]